Fourth nerve palsy: historical review and study of 215 inpatients.
A review of inpatient trochlear nerve pareses diagnosed over 23 years revealed head trauma as the principal cause, with surgical injury, inflammation, and brain tumors seen occasionally. Ischemic (microvascular) neuropathies were rare. About one-half of the patients (52%) had no other neuro-ophthalmologic signs, but only 5% were truly isolated, without other neurologic or ophthalmologic signs or symptoms. Fourth nerve palsies are underdiagnosed on hospital services, where stuporous patients encounter unsuspecting physicians.
Keane
J R
JR
Department of Neurology, Los Angeles County/University of Southern California Medical Center.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003389:Cranial Nerve Diseases / Q000150:complications / Q000209:etiology / Q000266:history; D005128:Eye Diseases / Q000150:complications; D005260:Female; D049669:History, 16th Century; D049670:History, 17th Century; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D007239:Infections / Q000150:complications; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D009462:Neurology / Q000266:history; D010243:Paralysis / Q000150:complications / Q000209:etiology*; D012189:Retrospective Studies; D014321:Trochlear Nerve; D061247:Trochlear Nerve Injuries; D014652:Vascular Diseases / Q000150:complications; D014947:Wounds and Injuries / Q000150:complications