Inferior oblique overaction in a congenital 4th nerve palsy

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Identifier Congenital_4th_IO_overaction
Title Inferior oblique overaction in a congenital 4th nerve palsy
Subject Fourth (Trochlear) Nerve Palsy
Creator Daniel R. Gold, DO, Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine
Description 60-yo-man complaining of intermittent oblique diplopia. There was a left hypertropia that worsened in down gaze, right gaze and in left head tilt. There was a large vertical fusional amplitude in addition to a longstanding rightward head tilt, and on examination there was left inferior oblique overaction. These features were highly suggestive of a congenital left 4th nerve palsy. Video shows left congenital 4th nerve palsy with left inferior oblique overaction seen in right gaze. This is not primary inferior oblique overaction, but is secondary to a superior oblique palsy. The positive head tilt test is consistent with a left SO palsy, while in primary IO overaction, it would be negative.
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2016
Type Image/MovingImage
Format video/mp4
Rights Management Copyright 2016. For further information regarding the rights to this collection, please visit:
Collection Neuro-ophthalmology Virtual Education Library: NOVEL
Language eng
ARK ark:/87278/s67t0xdh
Setname ehsl_novel_gold
Date Created 2016-08-30
Date Modified 2017-05-09
ID 187731
Reference URL
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