Trochlear nerve: central palsy

Evidence-based neurology checklist on trochlear nerve: central palsy: Clinical features Contralateral tinnitus: this is from involvement of the superior colliculus Upbeat or upbeat-torsional nystagmus Relative apparent relative defect (RAPD): this is ipsilateral or contralateral Associated cranial…

Clinical features

  • Contralateral tinnitus: this is from involvement of the superior colliculus
  • Upbeat or upbeat-torsional nystagmus
  • Relative apparent relative defect (RAPD): this is ipsilateral or contralateral

Associated cranial nerve palsies

Associated contralateral brainstem signs

Synonyms

References

  1. Gräf M, Krzizok T, Kaufmann H. Head-tilt test in unilateral and symmetric bilateral acquired trochlear nerve palsy. Klin Monbl Augenheilkd 2005; 222:142-149. 
  2. Thurtell MJ, Tomsak RL, Leigh RJ. Upbeat-torsional nystagmus and contralateral fourth-nerve palsy due to unilateral dorsal ponto mesencephalic lesion. Ann N Y Acad Sci 2009; 1164:476-478. 
  3. Miller NR. Pearls and oy-sters: central fourth nerve palsies. Neurology 2013; 81:603.
  4. Eliott D, Cunningham ET Jr, Miller NR. Fourth nerve paresis and ipsilateral relative afferent pupillary defect without visual sensory disturbance. A sign of contralateral dorsal midbrain disease. J Clin Neuroophthalmol 1991; 11:169-172. 
  5. Sharma V, Biswas S. Self-limiting fourth and sixth cranial nerve palsy after Lyme disease. J Pediatr Ophthalmol Strabismus 2010; 47:114-116. 
  6. And 8 more. Subscribe to see the full list

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