Isolated IV Nerve Palsy as First Sign in the Diagnostic of Lung Carcinoma

The two most common causes of fourth nerve palsy are trauma and decompensation of a congenital palsy. The nerve can be affect in the midbrain (nucleus of fascicle), in the subarachnoid space, in the cavernous sinus or in the orbital apex. Other non common causes of fourth nerve palsy include infarction, hemorrhage, demyelination, inflammation, infection, tumor and metastasis. The purpose of this poster is to present a case report of an atypical cause of isolated IV nerve palsy due to metastasis of a primary lung tumor unknown until then.