Neurogenic superior oblique palsy, also known as acquired superior oblique palsy or neurological fourth nerve palsy, refers to a condition characterized by impairment or weakness of the superior oblique muscle in the eye, resulting from damage or dysfunction in the nerves or the brain regions responsible for controlling eye movements.
The superior oblique muscle is one of the six extraocular muscles that control eye movements. Its primary function is to aid in rotating the eyeball outward and downward. However, in cases of neurogenic superior oblique palsy, this muscle is affected, leading to an inability or reduced capacity to move the eye in certain directions, particularly downward and inward.
The term "neurogenic" indicates that the underlying cause of this condition arises from neurological factors, such as damage to the trochlear nerve (also known as the fourth cranial nerve) or the brain regions that control eye movements. This damage may occur due to various reasons, including trauma, infection, inflammation, or a neurological disorder.
Individuals affected by neurogenic superior oblique palsy may experience a range of symptoms, including vertical or oblique double vision (diplopia), difficulty with downward gaze and convergence, tilting or tilting of the head to compensate for double vision, eye strain or fatigue, and problems with judging distances or depth perception. Treatment may involve addressing the underlying cause, prisms or occlusion therapy to alleviate symptoms of double vision, or in some cases, corrective eye surgery to reposition the affected eye muscles.
