Trochlear Nerve Palsy (Fourth Nerve Palsy) Questions & Answers

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

Overview

What is trochlear nerve palsy (fourth nerve palsy)?

When were surgical therapies first developed for trochlear nerve palsy (fourth nerve palsy)?

What are the types of trochlear nerve palsy (fourth nerve palsy)?

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

What causes trochlear nerve palsy (fourth nerve palsy)?

What is the pathophysiology of congenital trochlear nerve palsy (fourth nerve palsy)?

What is the pathophysiology of acquired trochlear nerve palsy (fourth nerve palsy)?

What are the signs and symptoms of trochlear nerve palsy (fourth nerve palsy)?

What are the signs and symptoms of congenital trochlear nerve palsy (fourth nerve palsy)?

When is surgical intervention indicated for the treatment of trochlear nerve palsy (fourth nerve palsy)?

What is the anatomy of the trochlear nucleus relevant to trochlear nerve palsy (fourth nerve palsy) treatment?

What are the contraindications for surgery to treat trochlear nerve palsy (fourth nerve palsy)?

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

What is included in the patient education about trochlear nerve palsy (fourth nerve palsy)?

Presentation

What is the focus of the clinical history to evaluate trochlear nerve palsy (fourth nerve palsy)?

What is included in the physical exam to evaluate trochlear nerve palsy (fourth nerve palsy)?

How is cyclotorsion assessed in trochlear nerve palsy (fourth nerve palsy)?

What is the role of the upright-supine test in the evaluation of trochlear nerve palsy (fourth nerve palsy)?

How is ocular tension assessed in trochlear nerve palsy (fourth nerve palsy)?

DDX

What are the differential diagnoses for Trochlear Nerve Palsy (Fourth Nerve Palsy)?

Workup

When is neuroimaging indicated in the workup of trochlear nerve palsy (fourth nerve palsy)?

Which lab tests are performed in the workup of trochlear nerve palsy (fourth nerve palsy)?

What is the role of MRI and MRA in the workup of trochlear nerve palsy (fourth nerve palsy)?

What is the role of CT scanning in the workup of trochlear nerve palsy (fourth nerve palsy)?

Treatment

What are the nonsurgical treatments for trochlear nerve palsy (fourth nerve palsy)?

What is the role of surgery in the treatment of trochlear nerve palsy (fourth nerve palsy)?

What is included in the preoperative care of trochlear nerve palsy (fourth nerve palsy)?

How is surgery performed for the treatment of trochlear nerve palsy (fourth nerve palsy)?

When is a second surgery required to treat trochlear nerve palsy (fourth nerve palsy)?

How are torsional symptoms treated following surgery for trochlear nerve palsy (fourth nerve palsy)?

What are the possible complications of trochlear nerve palsy (fourth nerve palsy) surgery?

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