May 7th, 2011
Fourth Nerve Palsy & Vertigo
Sue

I experienced vertigo over a month ago while on vacation. Could not get out of bed for an hour. Symptoms subsided then 4 days later had dizziness on and off. Found that in the afternoons I could not stand looking at the computer and was exhausted. A lot of double vision and was worse when I was tired. Went to an ENT who is testing me for positional vertigo or an inner ear problem. Taking a balance test on Wed Also went to neuro opthomolgist who diagnosed fourth nerve palsy. I had muscle surgery for a lazy eye when I was 4 and they missed this. Dr. said vertigo brought on the eye problem and the extreme fatigue. Has anyone else ever experienced this.
|
Did you find this post helpful?

replied June 23rd, 2011
My mother is 71 and two days ago she ended up in hospital and was diagnosed with 4th Nerve Palsy. She has had a history of Vertigo as long as I can remember and no one ever checked her eyes they always thought it was an inner ear problem. Now she also has diabetes which they say could have caused this as well. She was reading the TV guide and all of a sudden she got a sharp pain over her eye and then she was seeing double. She had a card to test for stroke symtoms but wasn't presenting with any of them. Doctors have told her a month or so and it should heal. But from reading all this I think that sounds really optomistic.
|
Did you find this post helpful?

replied June 6th, 2011
4th nerve palsy
I was bitten by a poisonous spider and within 30 minutes had double vision, along with many other symptoms....My husband thought I was having a stroke and took me to the ER. After 4 days of every kind of test (which all were normal), they released me. By then, all the symptoms (high blood pressure, nausea, headache, heart racing) had disappeared, except for the double vision. I went to the opthamalogist, who diagnosed 4th nerve palsy. He said it SHOULD clear up on it's own, but it's been over 6 weeks and I still have it. It is very annoying to wear a patch, but otherwise I get dizzy & nauseous. It is in my left eye. If I look to the right, it is OK and if I look up it is OK. The double vision is verticle, with the bottom image being slightly skewed. I went to the eye dr. the other day and he said it's the same, come back in 6 weeks.....
|
Did you find this post helpful?

replied August 22nd, 2012
monocular double vision
I woke up approx. 2 weeks ago with monocular double vision. I have had MRI's, catscan and blood test and nothing shows up. I am 58 with type 2 diabetes and I go back to see my neurologist next week. He said if it is a diabetic related nerve palsy it will go away on its own, but I am a truck driver and need to return to work but obviously can not drive this way. I am trying to find someone who has had this and it went away on its own. Thanks m2654
|
Did you find this post helpful?

replied August 22nd, 2012
monocular double vision
I woke up approx. 2 weeks ago with monocular double vision. I have had MRI's, catscan and blood test and nothing shows up. I am 58 with type 2 diabetes and I go back to see my neurologist next week. He said if it is a diabetic related nerve palsy it will go away on its own, but I am a truck driver and need to return to work but obviously can not drive this way. I am trying to find someone who has had this and it went away on its own. Thanks m2654
|
Did you find this post helpful?

replied September 13th, 2012
About a year ago I woke up with double vision, my left eye would only track up to a certain point and stop. I went to the Emergency Room and was provided a CT and MRI/MRA very quickly. My blood tests and scans were negative. My vision returned to normal after about 2 months. I have woke up a few days ago and it is back. I only notice when I look up and to the right. I saw an opthomologist yesterday and have been refered to a specialist at the Medical College of Virginia. I have been treated at the VA and cannot get any appointments with them, so I have decided to get seen outside the system. I will follow up with any news I receive from the Specialist.
|
Did you find this post helpful?

replied December 3rd, 2012
need a help please..
Hi all,
I am new to this blog. I had a TB meningitis last year and due to that I got double vision and diagnosed with 4th nerve palsy. My MRI shows 1 scar and dr. said that its a treated tb part in my head. I have been referred to ophthalmologist and they said we can't give any assurance that after eye surgery double vision problem will be resolved, it might get worse.
I am so confused what to do now. Is it like I need to live with this problem for whole life?

Any one can advise on my situation will be highly appreciated.
|
Did you find this post helpful?

replied December 14th, 2012
Hi all,

after 6 mths of patching, does the surgical solved the problems?
|
Did you find this post helpful?

replied April 9th, 2013
4 nerve palsy ...Any good Drs in the midwest?
I fell and landed just above my left temple. 4th nerve palsy, double vision, headaches and nausea. Its been 6 months and dr arent much help. Prism glasses are no help. Headache in eye n dizziness are most annoying. Any good drs in midwest?
|
Did you find this post helpful?

replied April 14th, 2013
4th nerve palsy. Causes?
A large percentage (this varies based on age) of 4 th nerve palsies are actually idiopathic (meaning no known cause). Another large percentage are decompensated congenital issues as the 4th nerve and the superior oblique muscle pulley (torclear notch) is one if the easiest structures to damage at birth. As we age we loose the ability to overcome this and the double vision shows up. There are some clues your eye doctor could have to hint at this. So please don't worry if you have recently been diagnosed. If you have no other vascular issues and no other concurrent neurological symptoms ESPECIALLY if you had a gradual or unknown onset there is a very high chance this is congenital or idiopathic.
|
Did you find this post helpful?

replied July 31st, 2013
Thank you for this advice. I was diagnosed with 4th Nerve Palsy last year and was prescribed prism glasses which helps at times. It is due to congenital causes since I had slight vision symptoms as a youth and had no serious medical incidents since then ( I am 60). Do you know if there any treatment for it other than wearing glasses.

Thanks again, John
|
Did you find this post helpful?

replied July 31st, 2013
There is a muscle resection surgery that can be done if the amount of prism gets to hard to handle. It is a relatively basic surgery and yields good results but occasionally will need to be redone. ---------------
An additional note on the idiopathic cause; modern research MRI scanners (not what the average patient gets) has shown anatomical vascular loops irritating the 4th nerve are often the cause. This doesn't change anything but now we know why idiopathic ones likely occur.
|
Did you find this post helpful?

replied August 20th, 2013
4th Nerve Palsy at 32 years old...
hello everyone. I appreciate hearing all your stories and also knowing I am not alone. I am a 32 year old female who was just diagnosed with right eye 4th nerve palsy about a month ago. I was at a conference in Florida when I developed double vision and had been working at (and staring at) my computer for 8 hours. After looking up from my computer at the end of the day I realized I was seeing double (it was not noted when looking at my computer screen during the day, but I believe I may have compensated throughout the day with the head tilt almost immediately). Once 24 hrs passed and it had not yet gone away, I went to the ER (the only place I could get in with my insurance out of state). The ER doctor was not very concerned and seemed to think it was more related to over use of computers and sent me on my way. A few days later I was traveling home (husband drove us back to Colorado from Florida), when vertigo, dizziness, and nausea hit full force. Therefore, I went to another hospital in Texas (felt the worse I have ever felt in my life). The doctor there felt strongly this may be MS related and insisted I do a CT scan and did some bloodwork. The CT scan noted a small fatty tissue near the optic nerve so the ER Dr. insisted I do an MRI as well. Following the MRI he did indicated that the fatty tissue appeared benign and he said while it was close to the nerve, he did not see it pressing on the nerve nor did he know if it could be related at that point - they sent me on my way home to Colorado to see further specialists.
I saw an ophthalmologist immediately upon being back who diagnosed me with 4th nerve palsy and sent me to a Neurologist. The Neurologist also has looked at my MRI and CT scan and indicated that I have no other symptoms that suggest MS, and he also does not believe that the fatty benign tissue appears to be hitting anything that should be of concern. He ran full blood work as well - thyroid, syphilis, bloodsugar, other viruses, and found nothing out of sort. He did note that my balance was off and suggested an inner ear problem may play into that (but he said my balance issue seemed to be related to the left side , not the right where my palsy is). He has ordered another MRI to take a closer look at the area, but this will probably take another month given how long my insurance takes to approve things, etc.. I also would like to note I have horrible vision (-6.5 in left eye, -5.5 in right). I have also had a tendency to turn my head to the left when reading, but did not note a consistent head tile in all my previous photos (although there was one there in some photos).
This is the most serious health problem I have had in my life. Up to this point I have been a fairly good model of picture perfect health. This year I just moved to Colorado from Florida and given the major temperature change and new environment I did find myself with the longest and most frequent rounds of sinus infections, colds, flus, that I had ever had. In April 2013, I had a large 6mm X 7 mm calcium stone removed from my salivary duct that had been there for at least 4 months. It was infected, but I did take antibiotics following the infection and assumed it had cleared up (Although my salivary gland remains slightly swollen to this day). I am wearing a prism 4, which sort of helps, but I still have a tendency to tilt my head to the left . If I tilt my head slightly to the right or look to the left, my double vision is still quite there (Even with the prism). In no way does the prism make me feel normal. I am dizzy, nauseous, and spin quite easily. I cannot even think about turning around without feeling like I may spin. I have not been able to drive and up until this week I could not work. The only reason I am working now is because I my work offered me a few weeks of completing paperwork from home. I work with children diagnosed with autism and I find that sort of activity nearly impossible to stomach at this time. Any words of advice, potential other underlying causes to consider, or even just words of support would be highly appreciated at this time. I have always been a bit of a hypochondriac so unfortunately, this has only reinforced my feelings of anxiety. Additionally, I am a generally very active person, and not being able to do my job and feeling like the only way I feel okay if I am sitting or laying down is really wearing on my emotions! Not to mention, I cannot even fathom driving! Thanks again for your previous posts, as they provided me some comfort during this time that this is not necessarily only a sign of a serious health condition!
|
Did you find this post helpful?

replied August 20th, 2013
Read below;
But very likely your equilibrium with the vertigo etc etc could be off and now your body is not able to over come a 4th nerve you've had for yrs. if its congenital your eye doctor should be able to tell based on old photos and your vertical vergence ranges. Not always but often. If it was around for a few yrs the equilibrium stuff could still just be the straw that broke the camels back when it comes to the 4th nerve. Also im not sure what state you are in but a lymes disease test would be good if you havent had one yet. Best of luck. (I would still ask about neuro suppressors like lyrica or similar. Even Dramamine)
|
Did you find this post helpful?

replied August 20th, 2013
Rely juliaus
Hi juliaus,
I am sorry to hear about your ordeal. It does sound like a complicated case. I would trust your neurologist and make sure you are tested for inner ear "stones". Little calcified deposits can occur in the ear labryths and then dislodge and really mess with our equilibrium. Now rarely does anything in the area of the ear affect the 4th nerve but if your MRI for a 4th nerve was clear/clean and your blood work normal then you have an idiopathic 4th nerve which is often caused by a microscopic blood vessel irritating the delicate 4th nerve sheath (no health concern with this). That said if your equilibrium is off your body may just be thrown off inducing the 4th. I have never seen this but I am trying to figure how the two are both occurring. Always trust your neurologist but I would ask him if you would possibly benefit from a neuro suppressing agent like lyrica or similar. Things involving equilibrium are very complicated as they involve your ears, eyes, cerebellum, and countless receptors in the body and other brain areas. Don't worry though my experience has been anxiety only worsens things like this. After awhile a basic eye surgery can be done for the double if prism does not solve it well enough. Hang in there; trust the scans and blood work. This may be too forward but I also suffer from anxiety (hypochondria is a form) and I find peace in this Bible verse "be anxious for nothing but in all things make your requests/worries be known to God through prayer and let the Peace of God which surpasses all understanding wash over you and give you rest". (Paraphrased)
|
Did you find this post helpful?

replied September 10th, 2013
Toddler 4th Nerve Palsy
Hello - my daughter ( age 12 months) was diagnosed with right 4th nerve palsy. She has been tilting to the left dice 4 or 5 months but I thought should had torticollis. Here are her symptoms: when sticking out tongue is goes to the left, she started walking at 10.5 months but is unstable, she has a hard time keeping her balance at times, looks down more than up (although this is getting much better), uneven thigh folds (right leg is slightly slimmer than left). Could all these symptoms be caused by right 4th nerve palsy or could something more be going on???
|
Did you find this post helpful?

replied October 9th, 2013
4th Nerve Palsey, aka: Trochler Nerve Palsey.
I developed double vision about 18 months ago and was diagnosed with Trochler Nerve Palsey (aka; 4th Nerve Palsey). I saw a Neuro-opthomologist who suggested I wait a year to see if it would resolve itself. 4 months in to it, the condition went away. 2 months after that it came back and has remained constant since then (about one full year). This problem has life changing consequences, ie, double vision, headaches and fatique just to name a few. I understand that their is a physician in Los Angeles who has developed a new curative procedure called "mini-tanatomy".

Several other sufferers have reported successful results from mini-tanatomy. If anyone reading this has contact information on this L A doctor, please post it. Thank you.
|
Did you find this post helpful?

replied October 15th, 2014
I have 4th nerve palsy due to surgery for epilepsy called laser ablation that I had 3 months ago. I participated in a research study for this new method of surgery. I have not had any seizures since then, but the doctors said I had 4th nerve palsy due to the heat from the laser getting too close to the nerve. I have to tilt my head to the right a little to bring things into focus, either that or wear an eye patch. I have no vertigo, and can still get around, but this vertical double vision is annoying. I have an appointment to see a Neuro-ophthalmologist on the 21st of this month.
|
Did you find this post helpful?

User Profile
replied September 25th, 2019
Hello, after reading I’d like to share my story I’m a 37 yr old male and I have been suffering from aggressive symptoms associated to fourth nerve palsy. I’ve been to numerous doctors in my state of N.J. to having three eye muscle surgeries at the Kellogg institute in Ann Arbor Michigan by dr delmonte.

I’ve been out of focus, light headed, blurry double/vision tightness in neck among symptoms I’ve also been to doctors and tried prism glasses with no success . I’m kinda at a loss as to where to turn next. I have a appt three months away with a doctor in Westfield name Dr. Vicci who I have seen before I might take the drive to Michigan again and see dr Debby Feinberg who I’ve seen before my surgeries. Any suggestions would be greatly appreciated
|
Did you find this post helpful?
12
Must Read
How can you tell if a headache is serious, or not? What types of headaches are there? Get started learning the facts about headache here....
Do you know when to seek help for headache symptoms? Learn more about symptoms of the four different types of headaches...and when to go to a doctor here....
Headaches can be caused by various medical conditions. Learn which tests doctors use to diagnose problem headaches...and who you should see to start diagnosis....