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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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