Tinnitus in fourth nerve palsy: an indicator for an intra-axial lesion.
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.
Choi
Seo Young
SY
Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Republic of Korea.
Song
Jae Jin
JJ
Hwang
Jeong Min
JM
Kim
Ji Soo
JS
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*