Trochlear Cranial Nerve IV Palsy

Exam Cram

• Trochlear nerve innervates the superior oblique intraocular muscle responsible for medial-inferior eye movements

• Presentation: inability to move eye inferiorly at ADDuction after trauma

• Aetiology: (Isolated)- congential, acquired- microvascular- diabetes, hypertension; trauma; (with other focal neurology: MS, Stroke, Lyme disease, meningitis etc. )

• Plan: MRI head- rule out space occupying lesion; hba1c, bp, esr/crp; eye patch, prism glasses, not driving