Central 4th nerve palsy with contralateral Horner's syndrome

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Identifier 4th & Horners
Title Central 4th nerve palsy with contralateral Horner's syndrome
Subject Horner's, Fourth nerve palsy, Mesencephalon
Creator Daniel R. Gold, DO, Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, The Johns Hopkins School of Medicine
Description This is a 60-yo-woman who presented with a complaint of diplopia. Examination demonstrated a left hypertropia that worsened in right and down gaze as well as in left head tilt, and a left 4th nerve palsy was diagnosed. There was also evidence of a mild motility deficit in down/medial gaze OS, consistent with paresis of the left superior oblique muscle. There was also right ptosis and miosis consistent with a right Horner's syndrome. In her case, there was a lesion of the right midbrain (turned out to be a small met from lung cancer), involving the fascicle and/or nucleus of right cranial nerve 4 (prior to its decussation) and the adjacent right (uncrossed) oculosympathetic tract. The combination of a 4th nerve palsy with contralateral Horner's (or INO) is highly suggestive of a central 4th nerve palsy given the trochlear nerve's unique decussation. Number of Figures and legend for each: 0 Number of Videos and legend for each: 1, Right Horner's syndrome with left 4th nerve palsy
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: https://NOVEL.utah.edu/about/copyright
Collection Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
ARK ark:/87278/s6gb5crm
Setname ehsl_novel_gold
Date Created 2016-09-07
Date Modified 2017-05-17
ID 187737
Reference URL https://collections.lib.utah.edu/ark:/87278/s6gb5crm
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