Biomaterial Database

Palsies of the third, fourth, and sixth cranial nerves. 2001

J L Bennett, and V S Pelak

Departments of Neurology and Ophthalmology, University of Colorado Health Sciences Center, Denver, Colorado, USA.

Diplopia is one of the most vexing problems to confront a physician. When diplopia is binocular, it commonly results from dysfunction of one or more of the ocular motor nerves. Ocular motor dysfunction may result from injury anywhere along the neuraxis, from the ocular motor nucleus to the myoneural junction. Identifying the location of the lesion is important for determining the etiology and prognosis of third-, fourth-, and sixth-nerve injuries. In this article, an anatomic approach is presented for the diagnosis and treatment of ocular motor nerve lesions. Emphasis is placed on the identification of associated neurologic and ophthalmologic findings that are critical for management of patients with acquired and congenital ocular motor palsies.

UI	MeSH Term	Description	Entries
D004172	Diplopia	A visual symptom in which a single object is perceived by the visual cortex as two objects rather than one. Disorders associated with this condition include REFRACTIVE ERRORS; STRABISMUS; OCULOMOTOR NERVE DISEASES; TROCHLEAR NERVE DISEASES; ABDUCENS NERVE DISEASES; and diseases of the BRAIN STEM and OCCIPITAL LOBE.	Double Vision,Polyopsia,Diplopia, Cortical,Diplopia, Horizontal,Diplopia, Intermittent,Diplopia, Monocular,Diplopia, Refractive,Diplopia, Unilateral,Diplopia, Vertical,Cortical Diplopia,Cortical Diplopias,Diplopias,Diplopias, Cortical,Diplopias, Horizontal,Diplopias, Intermittent,Diplopias, Monocular,Diplopias, Refractive,Diplopias, Unilateral,Diplopias, Vertical,Horizontal Diplopia,Horizontal Diplopias,Intermittent Diplopia,Intermittent Diplopias,Monocular Diplopia,Monocular Diplopias,Polyopsias,Refractive Diplopia,Refractive Diplopias,Unilateral Diplopia,Unilateral Diplopias,Vertical Diplopia,Vertical Diplopias,Vision, Double
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013285	Strabismus	Misalignment of the visual axes of the eyes. In comitant strabismus the degree of ocular misalignment does not vary with the direction of gaze. In noncomitant strabismus the degree of misalignment varies depending on direction of gaze or which eye is fixating on the target. (Miller, Walsh & Hoyt's Clinical Neuro-Ophthalmology, 4th ed, p641)	Concomitant Strabismus,Dissociated Horizontal Deviation,Dissociated Vertical Deviation,Heterophoria,Heterotropias,Hypertropia,Non-Concomitant Strabismus,Nonconcomitant Strabismus,Phorias,Squint,Strabismus, Comitant,Strabismus, Noncomitant,Convergent Comitant Strabismus,Mechanical Strabismus,Comitant Strabismus,Comitant Strabismus, Convergent,Deviation, Dissociated Horizontal,Dissociated Horizontal Deviations,Dissociated Vertical Deviations,Heterophorias,Heterotropia,Horizontal Deviation, Dissociated,Hypertropias,Non Concomitant Strabismus,Noncomitant Strabismus,Phoria,Strabismus, Concomitant,Strabismus, Convergent Comitant,Strabismus, Mechanical,Strabismus, Non-Concomitant,Strabismus, Nonconcomitant
D015840	Oculomotor Nerve Diseases	Diseases of the oculomotor nerve or nucleus that result in weakness or paralysis of the superior rectus, inferior rectus, medial rectus, inferior oblique, or levator palpebrae muscles, or impaired parasympathetic innervation to the pupil. With a complete oculomotor palsy, the eyelid will be paralyzed, the eye will be in an abducted and inferior position, and the pupil will be markedly dilated. Commonly associated conditions include neoplasms, CRANIOCEREBRAL TRAUMA, ischemia (especially in association with DIABETES MELLITUS), and aneurysmal compression. (From Adams et al., Principles of Neurology, 6th ed, p270)	Cranial Nerve III Diseases,Third-Nerve Palsy,Oculomotor Nerve Disorders,Oculomotor Nerve Palsy,Oculomotor Nerve Paralysis,Oculomotor Neuropathy,Partial Third-Nerve Palsy,Third Cranial Nerve Diseases,Third-Nerve Paralysis,Total Third-Nerve Palsy,Nerve Disease, Oculomotor,Nerve Disorder, Oculomotor,Nerve Palsy, Oculomotor,Nerve Paralysis, Oculomotor,Neuropathy, Oculomotor,Oculomotor Nerve Disease,Oculomotor Nerve Disorder,Oculomotor Nerve Palsies,Oculomotor Nerve Paralyses,Oculomotor Neuropathies,Palsy, Oculomotor Nerve,Palsy, Partial Third-Nerve,Palsy, Third-Nerve,Palsy, Total Third-Nerve,Paralysis, Oculomotor Nerve,Paralysis, Third-Nerve,Partial Third Nerve Palsy,Partial Third-Nerve Palsies,Third Nerve Palsy,Third Nerve Paralysis,Third-Nerve Palsies,Third-Nerve Palsies, Partial,Third-Nerve Palsy, Partial,Third-Nerve Palsy, Total,Third-Nerve Paralyses,Total Third Nerve Palsy,Total Third-Nerve Palsies
D020432	Trochlear Nerve Diseases	Diseases of the fourth cranial (trochlear) nerve or its nucleus in the midbrain. The nerve crosses as it exits the midbrain dorsally and may be injured along its course through the intracranial space, cavernous sinus, superior orbital fissure, or orbit. Clinical manifestations include weakness of the superior oblique muscle which causes vertical DIPLOPIA that is maximal when the affected eye is adducted and directed inferiorly. Head tilt may be seen as a compensatory mechanism for diplopia and rotation of the visual axis. Common etiologies include CRANIOCEREBRAL TRAUMA and INFRATENTORIAL NEOPLASMS.	Cranial Nerve IV Diseases,Fourth Cranial Nerve Diseases,Fourth Cranial Nerve Palsy,Fourth Nerve Palsy,Neurogenic Superior Oblique Palsy,Superior Oblique Myokymia,Superior Oblique Palsy, Neurogenic,Trochlear Nerve Disorders,Trochlear Nerve Palsy,Trochlear Neuropathy,Fourth Nerve Palsies,Myokymia, Superior Oblique,Myokymias, Superior Oblique,Neuropathies, Trochlear,Neuropathy, Trochlear,Palsies, Fourth Nerve,Palsies, Trochlear Nerve,Palsy, Fourth Nerve,Palsy, Trochlear Nerve,Superior Oblique Myokymias,Trochlear Nerve Disease,Trochlear Nerve Disorder,Trochlear Nerve Palsies,Trochlear Neuropathies
D020434	Abducens Nerve Diseases	Diseases of the sixth cranial (abducens) nerve or its nucleus in the pons. The nerve may be injured along its course in the pons, intracranially as it travels along the base of the brain, in the cavernous sinus, or at the level of superior orbital fissure or orbit. Dysfunction of the nerve causes lateral rectus muscle weakness, resulting in horizontal diplopia that is maximal when the affected eye is abducted and ESOTROPIA. Common conditions associated with nerve injury include INTRACRANIAL HYPERTENSION; CRANIOCEREBRAL TRAUMA; ISCHEMIA; and INFRATENTORIAL NEOPLASMS.	Abducens Palsy, Childhood, Benign Recurrent,Cranial Nerve VI Diseases,Lateral Rectus Palsy,Sixth Cranial Nerve Disorders,6th Nerve Palsy,Abducens Nerve Palsy,Abducens Palsy,Benign Recurrent Abducens Palsy of Childhood,Benign Recurrent Abducens Palsy, Children,Cranial Nerve VI Palsy,Sixth Cranial Nerve Diseases,Sixth Cranial Nerve Palsy,Sixth Nerve Palsy,VI Nerve Palsy,VIth Cranial Nerve Diseases,6th Nerve Palsies,Abducens Nerve Disease,Abducens Nerve Palsies,Abducens Palsies,Lateral Rectus Palsies,Palsies, 6th Nerve,Palsies, Abducens,Palsies, Abducens Nerve,Palsies, Lateral Rectus,Palsies, Sixth Nerve,Palsies, VI Nerve,Palsy, 6th Nerve,Palsy, Abducens,Palsy, Abducens Nerve,Palsy, Lateral Rectus,Palsy, Sixth Nerve,Palsy, VI Nerve,Sixth Nerve Palsies