CN4 Differential

There are many causes for a 4th nerve palsy. Like the other cranial nerves, vasculopathic problems like diabetes and hypertension are common. Tumor can also cause a palsy because the fourth nerve has a long course through the cranial vault. Congenital palsies are common in children and often overlooked because children learn to adapt with a head tilt. Trauma can also cause a palsy because of the long and skinny nerve.