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Published on: March 1, 2015
Disorders of the Fourth Cranial Nerve
Lanning B Kline1, Joseph L Demer, Michael S Vaphiades
1Department of Ophthalmology, University of Alabama School of Medicine (LBK, MSV, MT), Birmingham, Alabama; The Shiley Eye Institute, University of California San Diego (LBK), San Diego, California; and The Jules Stein Eye Institute, University of California, Los Angeles (JLD), Los Angeles, California.
Abstract:
This review of disorders of the fourth cranial nerve includes discussion on anatomy, examination techniques, congenital and acquired etiologies, differential diagnosis, and management options. The findings of the superior oblique muscle on orbital MRI in patients with fourth nerve palsy have had a major impact on our understanding of this cranial neuropathy. In addition, briefly reviewed are rare disorders of the fourth nerve: superior oblique myokymia, Brown syndrome, and ocular neuromyotonia. It behooves the clinician to have a clear understanding of the role that the fourth cranial nerve plays in a variety of neuro-ophthalmic conditions.
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