Document Detail

Trochlear palsies caused by isolated trochlear schwannomas.
MedLine Citation:
PMID:  20843184     Owner:  NLM     Status:  In-Process    
PURPOSE: To describe clinical features and management of 4 patients suffering from unilateral superior oblique palsies due to MRI-documented trochlear nerve schwannomas.
METHODS: Chart reviews of 4 patients seen at the departments of ophthalmogy and neurology at the University of Mainz.
RESULTS: All four patients were male, aged 36 to 72 years at initial presentation. None suffered from neurofibromatosis. The history of double vision prior presentation was 9 months to 13 years, follow-up time was 9 to 156 months. Two patients didn't receive any intervention: one remained stable over the follow-up time of 9 months. In patient #2, fourth nerve palsy was diagnosed 13 years prior to confirmation of a trochlear schwannoma by high-resolution MRI. In the third patient disturbing diplopia and head tilt were sufficiently corrected by strabismus surgery (combined oblique muscle surgery). The fourth patient had received stereotactic radiotherapy of an 8 mm schwannoma. He remained unchanged in the orthoptic measurements for 3,5 years. None of these patients developed any additional symptoms or signs of further cranial nerve or central nervous system involvement.
CONCLUSION: A trochlear nerve schwannoma is a possible cause of an isolated unilateral superior oblique palsy. MRI is a helpful tool for diagnosis and follow-up. Conservative management seems to be justified as patients can remain unchanged over years.
H M Elflein; F Thömke; W Müller-Forell; S Pitz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Strabismus     Volume:  18     ISSN:  1744-5132     ISO Abbreviation:  Strabismus     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9310896     Medline TA:  Strabismus     Country:  England    
Other Details:
Languages:  eng     Pagination:  83-6     Citation Subset:  IM    
Department of Ophthalmology, University Medicine Centre, Johannes Gutenberg - University, Mainz, Germany.
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