Trochlear Nerve Diseases (Fourth Nerve Palsy)

Diseases of the fourth cranial (trochlear) nerve or its nucleus in the midbrain. The nerve crosses as it exits the midbrain dorsally and may be injured along its course through the intracranial space, cavernous sinus, superior orbital fissure, or orbit. Clinical manifestations include weakness of the superior oblique muscle which causes vertical DIPLOPIA that is maximal when the affected eye is adducted and directed inferiorly. Head tilt may be seen as a compensatory mechanism for diplopia and rotation of the visual axis. Common etiologies include CRANIOCEREBRAL TRAUMA and INFRATENTORIAL NEOPLASMS.
Also Known As:
Fourth Nerve Palsy; Trochlear Nerve Palsy; Superior Oblique Myokymia; Fourth Cranial Nerve Palsy; Neurogenic Superior Oblique Palsy; Superior Oblique Palsy, Neurogenic; Trochlear Nerve Disorders; Trochlear Neuropathy; Fourth Nerve Palsies; Myokymia, Superior Oblique; Myokymias, Superior Oblique; Neuropathies, Trochlear; Neuropathy, Trochlear; Palsies, Fourth Nerve; Palsies, Trochlear Nerve; Palsy, Fourth Nerve; Palsy, Trochlear Nerve; Superior Oblique Myokymias; Trochlear Nerve Disease; Trochlear Nerve Disorder; Trochlear Nerve Palsies; Trochlear Neuropathies; Cranial Nerve IV Diseases; Fourth Cranial Nerve Diseases
Networked: 34 relevant articles (5 outcomes, 0 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1. Graves Ophthalmopathy
2. Vestibular Neuronitis (Vestibular Neuritis)
3. Pathologic Nystagmus
4. Cogan Syndrome
5. Congenital Nystagmus


1. Straube, Andreas: 2 articles (04/2005 - 02/2005)
2. Rusu, Mugurel Constantin: 1 article (07/2015)
3. Pătraşcu, Jenel Marian: 1 article (07/2015)
4. Vrapciu, Alexandra Diana: 1 article (07/2015)
5. Scott, Chris: 1 article (08/2014)
6. Fam, M Delour: 1 article (08/2014)
7. Kamel, Mahmoud H: 1 article (08/2014)
8. Forster, Alan: 1 article (08/2014)
9. Borgman, Christopher J: 1 article (04/2014)
10. Yoon, Keon Jung: 1 article (04/2013)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Trochlear Nerve Diseases:
1. gabapentin (Neurontin)FDA LinkGeneric
2. Carbamazepine (Tegretol)FDA LinkGeneric
3. Botulinum Toxins (Botulinum Toxin)IBA
4. Memantine (Namenda)FDA Link
5. Gadolinium DTPA (Magnevist)FDA Link
6. Paroxetine (Paxil)FDA LinkGeneric
7. Serotonin Uptake Inhibitors (Serotonin Reuptake Inhibitors)IBA
8. Timolol (Blocadren)FDA LinkGeneric
9. Propranolol (Inderal)FDA LinkGeneric
10. Minocycline (Cyclops)FDA LinkGeneric

Therapies and Procedures

1. Decompression
2. Surgical Decompression
3. Spinal Anesthesia
4. Tenotomy
5. Anterior Temporal Lobectomy