What is the prognosis of trochlear nerve palsy (fourth nerve palsy)?

Updated: Oct 08, 2019
  • Author: Zafar A Sheik, MD, MD; Chief Editor: Andrew G Lee, MD  more...
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Answer

The prognosis of a fourth nerve palsy depends on the underlying etiology. Congenital palsies are long standing and often remain static. Acquired, demyelinating (rare), traumatic, ischemic (microvascular), and idiopathic palsies usually resolve over time. The prognosis of fourth nerve palsies due to a structural lesion depend on the treatment of the underlying lesion. Most patients with symptoms that do not recover spontaneously can improve with prism or surgery.


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