Am Orthopt J  49: 134-138  (1999).

Acquired Fourth Nerve Palsies in Childhood

Chris Timms, D.B.O.(T)

All acquired cranial nerve palsies in childhood are rare. Rush and Younge in a retrospective study of 1000 cases of acquired palsies found that only 10% were under 19 years of age at presentation. There are reports of tumours causing sixth nerve palsies in children. Tumours, most commonly pontine gliomas, are reported to cause VIth nerve palsies, and sixth nerve palsies have been reported in a variety of brain tumours, particularly in the posterior fossa. Sixth nerve palsy is often associated with raised intracranial pressure from a variety of causes, However, a review of the literature reveals few reports of acquired fourth nerve palsies in children, By a retrospective analysis of case notes we investigated the occurrence of acquired fourth nerve palsies at Great Ormond Street Hospital for Children and found that the problem might not be as uncommon as the literature would suggest. We present here examples of those patients in order to raise awareness of the signs and symptoms of fourth nerve palsy in children and the possibility of this condition in patients with hydrocephalus.

© 1999 The Board of Regents of the University of Wisconsin System