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Volume 45, 1995, p. 24–33

Abnormal Head Posture in Patients with Fourth Cranial Nerve Palsy (Abstract)
Richard A. Saunders, M.D., Eric L. Roberts, M.D.

Ocular torticollis is a common finding and often the presenting complaint in patients with fourth cranial nerve or superior oblique muscle palsy. In most cases, a head posture is adopted which eliminates diplopia and/or allows singular binocular vision. Successful treatment, whether by prisms or extraocular muscle surgery, requires alignment of the eyes in primary gaze position. Surgical over correction in the presence of a positive Bielschowsky head tilt test will produce an opposite compensatory head tilt which may simulate unmasked, bilateral superior oblique muscle palsy.

 

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