U.S. flag

An official website of the United States government

Format

Send to:

Choose Destination

Trochlear nerve disorder

MedGen UID:
888203
•Concept ID:
C4048184
•
Disease or Syndrome
Synonym: Trochlear nerve disease
 
Monarch Initiative: MONDO:0007002

Definition

A non-neoplastic or neoplastic disorder affecting the trochlear nerve (IVth cranial nerve). [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVTrochlear nerve disorder

Professional guidelines

PubMed

Trochlear pain: clinical characteristics and treatment outcomes.
Chanlalit W, Teeyapant C, Soodchuen S
J Neurol 2018 Feb;265(2):376-380. Epub 2017 Dec 18 doi: 10.1007/s00415-017-8713-7. PMID: 29255927
Treatment and diagnosis of congenital fourth nerve palsies: an update.
Engel JM
Curr Opin Ophthalmol 2015 Jul;26(5):353-6. doi: 10.1097/ICU.0000000000000179. PMID: 26247132
Clinical utility and assessment of cyclodeviation.
Lemos J, Eggenberger E
Curr Opin Ophthalmol 2013 Nov;24(6):558-65. doi: 10.1097/ICU.0000000000000003. PMID: 24100374

Recent clinical studies

Etiology

Masquerading Superior Oblique Palsy.
Demer JL, Clark RA
Am J Ophthalmol 2022 Oct;242:197-208. Epub 2022 May 23 doi: 10.1016/j.ajo.2022.05.017. PMID: 35618024Free PMC Article
Superior oblique myokymia.
Zhang M, Gilbert A, Hunter DG
Surv Ophthalmol 2018 Jul-Aug;63(4):507-517. Epub 2017 Oct 19 doi: 10.1016/j.survophthal.2017.10.005. PMID: 29056504
Isolated third, fourth, and sixth cranial nerve palsies from presumed microvascular versus other causes: a prospective study.
Tamhankar MA, Biousse V, Ying GS, Prasad S, Subramanian PS, Lee MS, Eggenberger E, Moss HE, Pineles S, Bennett J, Osborne B, Volpe NJ, Liu GT, Bruce BB, Newman NJ, Galetta SL, Balcer LJ
Ophthalmology 2013 Nov;120(11):2264-9. Epub 2013 Jun 6 doi: 10.1016/j.ophtha.2013.04.009. PMID: 23747163Free PMC Article
Paralytic strabismus.
Schiavi C
Curr Opin Ophthalmol 2000 Oct;11(5):318-23. doi: 10.1097/00055735-200010000-00005. PMID: 11148696
Brown's syndrome.
Wilson ME, Eustis HS Jr, Parks MM
Surv Ophthalmol 1989 Nov-Dec;34(3):153-72. doi: 10.1016/0039-6257(89)90100-8. PMID: 2694414

Diagnosis

Superior oblique myokymia.
Zhang M, Gilbert A, Hunter DG
Surv Ophthalmol 2018 Jul-Aug;63(4):507-517. Epub 2017 Oct 19 doi: 10.1016/j.survophthal.2017.10.005. PMID: 29056504
Trochlear nerve palsy.
Morillon P, Bremner F
Br J Hosp Med (Lond) 2017 Mar 2;78(3):C38-C40. doi: 10.12968/hmed.2017.78.3.C38. PMID: 28277775
Isolated Ocular Motor Nerve Palsies.
Kung NH, Van Stavern GP
Semin Neurol 2015 Oct;35(5):539-48. Epub 2015 Oct 6 doi: 10.1055/s-0035-1563568. PMID: 26444399
Isolated third, fourth, and sixth cranial nerve palsies from presumed microvascular versus other causes: a prospective study.
Tamhankar MA, Biousse V, Ying GS, Prasad S, Subramanian PS, Lee MS, Eggenberger E, Moss HE, Pineles S, Bennett J, Osborne B, Volpe NJ, Liu GT, Bruce BB, Newman NJ, Galetta SL, Balcer LJ
Ophthalmology 2013 Nov;120(11):2264-9. Epub 2013 Jun 6 doi: 10.1016/j.ophtha.2013.04.009. PMID: 23747163Free PMC Article
Central trochlear palsy.
Mansour AM, Reinecke RD
Surv Ophthalmol 1986 Mar-Apr;30(5):279-97. doi: 10.1016/0039-6257(86)90061-5. PMID: 3520909

Therapy

Trochlear pain: clinical characteristics and treatment outcomes.
Chanlalit W, Teeyapant C, Soodchuen S
J Neurol 2018 Feb;265(2):376-380. Epub 2017 Dec 18 doi: 10.1007/s00415-017-8713-7. PMID: 29255927
Superior oblique myokymia.
Zhang M, Gilbert A, Hunter DG
Surv Ophthalmol 2018 Jul-Aug;63(4):507-517. Epub 2017 Oct 19 doi: 10.1016/j.survophthal.2017.10.005. PMID: 29056504
Supraorbital and supratrochlear stimulation for trigeminal autonomic cephalalgias.
Vaisman J, Lopez E, Muraoka NK
Curr Pain Headache Rep 2014 Apr;18(4):409. doi: 10.1007/s11916-014-0409-4. PMID: 24562664
Paralytic strabismus.
Byles DB, Elston JS
Curr Opin Ophthalmol 1998 Oct;9(5):20-3. doi: 10.1097/00055735-199810000-00005. PMID: 10387476
Neuro-ophthalmology.
Thompson HS
Arch Ophthalmol 1971 Oct;86(4):462-82. doi: 10.1001/archopht.1971.01000010464021. PMID: 4329269

Prognosis

Segmental Imaging of the Trochlear Nerve: Anatomic and Pathologic Considerations.
Agarwal N, Ahmed AK, Wiggins RH 3rd, McCulley TJ, Kontzialis M, Macedo LL, Choudhri AF, Ditta LC, Ishii M, Gallia GL, Aygun N, Blitz AM
J Neuroophthalmol 2021 Mar 1;41(1):e7-e15. doi: 10.1097/WNO.0000000000001125. PMID: 33136684
Neuro-Ophthalmic Manifestations of Acute Leukemia.
Alrobaian MA, Henderson AD
J Neuroophthalmol 2021 Dec 1;41(4):e584-e590. doi: 10.1097/WNO.0000000000001071. PMID: 32868572
Superior oblique myokymia.
Zhang M, Gilbert A, Hunter DG
Surv Ophthalmol 2018 Jul-Aug;63(4):507-517. Epub 2017 Oct 19 doi: 10.1016/j.survophthal.2017.10.005. PMID: 29056504
Paralytic strabismus.
Byles DB, Elston JS
Curr Opin Ophthalmol 1998 Oct;9(5):20-3. doi: 10.1097/00055735-199810000-00005. PMID: 10387476
Brown's syndrome.
Wilson ME, Eustis HS Jr, Parks MM
Surv Ophthalmol 1989 Nov-Dec;34(3):153-72. doi: 10.1016/0039-6257(89)90100-8. PMID: 2694414

Clinical prediction guides

Superior oblique myokymia, a review.
Tandon A, Oliveira C
Curr Opin Ophthalmol 2019 Nov;30(6):472-475. doi: 10.1097/ICU.0000000000000619. PMID: 31503076
Isolated Ocular Motor Nerve Palsies.
Pineles SL, Velez FG
J Binocul Vis Ocul Motil 2018 Jul-Sep;68(3):70-77. Epub 2018 Jun 21 doi: 10.1080/2576117X.2018.1481266. PMID: 30196784
Schwannoma of the trochlear nerve-an illustrated case series and a systematic review of management.
Torun N, Laviv Y, Jazi KK, Mahadevan A, Bhadelia RA, Matthew A, Strominger M, Kasper EM
Neurosurg Rev 2018 Jul;41(3):699-711. Epub 2016 Sep 1 doi: 10.1007/s10143-016-0783-y. PMID: 27586875
Isolated third, fourth, and sixth cranial nerve palsies from presumed microvascular versus other causes: a prospective study.
Tamhankar MA, Biousse V, Ying GS, Prasad S, Subramanian PS, Lee MS, Eggenberger E, Moss HE, Pineles S, Bennett J, Osborne B, Volpe NJ, Liu GT, Bruce BB, Newman NJ, Galetta SL, Balcer LJ
Ophthalmology 2013 Nov;120(11):2264-9. Epub 2013 Jun 6 doi: 10.1016/j.ophtha.2013.04.009. PMID: 23747163Free PMC Article
Congenital superior oblique palsy and trochlear nerve absence: a clinical and radiological study.
Yang HK, Kim JH, Hwang JM
Ophthalmology 2012 Jan;119(1):170-7. Epub 2011 Sep 15 doi: 10.1016/j.ophtha.2011.06.038. PMID: 21924501

Recent systematic reviews

COVID-19 and sudden-onset ocular neurogenic palsy in prior healthy patients: a systematic review.
Spiteri R, Barakat S, Vukicevic M
Strabismus 2023 Jun;31(2):145-151. Epub 2023 Jul 13 doi: 10.1080/09273972.2023.2232419. PMID: 37448224
Surgical Treatment of Trochlear Nerve Schwannomas: Case Series and Systematic Review.
Ozoner B, Gungor A, Ture H, Ture U
World Neurosurg 2022 Jun;162:e288-e300. Epub 2022 Mar 9 doi: 10.1016/j.wneu.2022.03.006. PMID: 35276398
Frequency of Diplopia after Intraoperative Nerve Disturbance in Trochlear Nerve Schwannoma: A Case Report and Systematic Review.
Fujiwara E, Adachi K, Tateyama S, Hasegawa M, Hirose Y
Neurol Med Chir (Tokyo) 2021 Oct 15;61(10):591-597. Epub 2021 Jul 28 doi: 10.2176/nmc.oa.2021-0079. PMID: 34321383Free PMC Article
Schwannoma of the trochlear nerve-an illustrated case series and a systematic review of management.
Torun N, Laviv Y, Jazi KK, Mahadevan A, Bhadelia RA, Matthew A, Strominger M, Kasper EM
Neurosurg Rev 2018 Jul;41(3):699-711. Epub 2016 Sep 1 doi: 10.1007/s10143-016-0783-y. PMID: 27586875

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.
    • Bookshelf
      See practice and clinical guidelines in NCBI Bookshelf. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Consumer resources

    Reviews

    Related information

    • MeSH
      Related Medical Subject Headings
    • PMC Articles
      Related information in PubMed Central Links
    • PubMed
      Related literature resources in PubMed

    Recent activity

    Clear Turn Off Turn On

    Your browsing activity is empty.

    Activity recording is turned off.

    Turn recording back on

    See more...