What is a Fourth Nerve Palsy?
A fourth nerve palsy, also known as a palsy of the Trochlear nerve, can be extremely debilitating for an individual. The movements of the eye are powered by three different nerves:
- The third cranial nerve also called the oculomotor nerve
- The fourth cranial nerve also called the trochlear nerve
- The sixth cranial nerve also called the abducens nerve
These three nerves work together to power the various motions of the eyes. The fourth cranial nerve powers the superior oblique muscle, which helps to move the eye both inward and downward. The superior oblique muscle enters the eye socket from the back and runs up to the top of the eye. At this location, the fourth cranial nerve attaches to the superior oblique muscle and helps to power its movements. If the fourth cranial nerve is damaged, the connection between the brain and the superior oblique muscle is severed. This will prevent the superior oblique muscle from moving and will deprive the eye of some of its movements, leading to visual difficulties. Because of this, it is essential to understand how a fourth nerve palsy develops, the signs and symptoms of the fourth nerve palsy, and the treatment options.
Mechanisms of a Fourth Nerve Palsy
There are several different ways that someone might develop a palsy of the fourth cranial nerve. Some of the possible examples include:
- Some people are born with issues with the fourth nerve which is called congenital fourth nerve palsy.
- Other individuals might develop a tumor behind the eyes that starts to press on their fourth nerve.
- The most common cause of the fourth nerve in adults is a traumatic injury.
Traumatic injuries to the 4th cranial nerve can lead to severe symptoms. In some cases, people might think that the accident was relatively minor and might not lead to any long-term consequences. The fourth nerve is the longest cranial nerve. This means that everything from a concussion to a cervical spine injury could lead to a severe fourth nerve injury. Because of this, everyone should know how to spot the signs and symptoms of trochlear nerve damage.
The Symptoms of a Trochlear Nerve Palsy
The diagnosis of a fourth nerve palsy starts by looking at the signs and symptoms. If someone presents to the doctor with a history that is compatible with a fourth nerve injury, such as a blow to the head or neck area in an auto accident, the doctor is going to ask about the symptoms. Some of the most common symptoms include:
- Double vision that occurs only when both eyes are open
- With either eye closed, individuals still see one image
- One iris might appear higher than the other
- A persistent tilt of the head that helps the double vision issue
- Pain behind the eyebrow near where the fourth nerve inserts into the superior oblique muscle
Anyone who presents with these symptoms might have a palsy of the fourth nerve. The doctor might order imaging scans, blood tests, or even a nerve stimulation study to test the function of the fourth cranial nerve.
Watch YouTube Video: Cranial Nerve 4 Palsy. This animated video provides an overview of Cranial Nerve 4 Palsy and its causes.
What are the Treatment Options?
Like other medical conditions and injuries, the treatment is going to depend on the cause of the fourth nerve palsy. Many fourth nerve palsies will heal on their own; however, damage to the fourth cranial nerve due to injury might not improve without medical treatment. The treatment is going to consist of:
- Medications used to help relieve the swelling following an accident such as Tylenol and Motrin.
- Specialized glasses that can help realign the eyes and the images.
- Surgery that can be used to correct the palsy or realign the eyes.
The goal of every fourth nerve palsy is to alleviate the double vision, also known as diplopia. This will also relieve anyone who has developed a head tilt. Surgery is used for severe cases.
Contacting an Injury Lawyer
If an individual has been involved in a major auto accident and subsequently been diagnosed with a fourth nerve palsy, this can lead to severe quality of life issues. In some cases, the fourth cranial nerve might never heal. This could lead to visual difficulties that might last for the rest of someone’s life. These vision problems can make it hard for someone to return to work or school, causing significant issues for a family. In this situation, it is essential for families to sit down and speak with a personal injury lawyer in Sacramento. Some of the ways that an injury lawyer can help include:
- Taking a look at the records from the accident to make sure that every detail has been considered
- Working with accident reconstruction professionals who can recreate exactly what happened at the scene of the crash
- Help families pursue damages that are related to the accident, any injuries, their complications, and even pain and suffering
- Shift a case to trial when required
No family should ever feel obligated to face such a tough situation alone. Meeting with an experienced Sacramento personal injury lawyer can be helpful. Reach out for help today. Your family could be owed a financial reward.
Sacramento Personal Injury Attorney
I’m Ed Smith, a Personal Injury Lawyer in Sacramento. A palsy of the fourth cranial nerve can lead to severe visual difficulties that might impact someone for the rest of his or her life. If you or someone you love has developed a palsy of a cranial nerve, please give me a call at (800) 404-5400 or (916) 921-6400 for free, friendly legal advice.
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