clinical features
Last reviewed 01/2018
The clinical features of a fourth cranial nerve palsy include:
- diplopia - particularly marked in reading
- abnormal head posture - head tilted towards the normal side, face rotated towards the normal side, and the chin is depressed. The affected eye is higher than its fellow.
- positive head tilt test - affected eye moves higher when the head is tilted towards the affected side
- early secondary contracture of the inferior oblique may occur resulting in greater hypertropia in upward gaze than in downward gaze