title: Tinnitus in fourth nerve palsy: an indicator for an intra-axial lesion.
abstract: Accompanying neurological symptoms and signs are diagnostic hallmarks of fourth nerve palsy (4NP) from an intra-axial lesion. Due to the proximity of the trochlear nucleus and fascicles to the inferior colliculus (IC), auditory symptoms including tinnitus may occur with an intra-axial 4NP. A 53-year-old man with hypertension and diabetes developed right 4NP with a sudden worsening of tinnitus. MRI disclosed an infarction involving the trochlear fascicle and IC in the left dorsal midbrain. Tinnitus may be a symptom indicating an intra-axial lesion causing a 4NP.
authors.affiliation: Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Republic of Korea.
authors.forename: Seo Young
authors.initials: SY
authors.lastname: Choi
authors.forename: Jae Jin
authors.initials: JJ
authors.lastname: Song
authors.forename: Jeong Min
authors.initials: JM
authors.lastname: Hwang
authors.forename: Ji Soo
authors.initials: JS
authors.lastname: Kim
mesh_terms: D020526:Brain Stem Infarctions / Q000150:complications* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014012:Tinnitus / Q000209:etiology* / Q000473:pathology*; D016896:Treatment Outcome; D020432:Trochlear Nerve Diseases / Q000209:etiology* / Q000473:pathology*