Fourth cranial nerve paly in pediatric patient with peudotumor cerebri

PURPOE: To decribe three children with acute fourth cranial nerve paly econdary to peudotumor cerebri. METHOD: We reviewed the medical record of children younger than 18 year who were diagnoed with peudotumor cerebri between 1977 and 1997. Peudotumor cerebri wa defined by normal neuro-imaging, elevated intracranial preure meaured by lumbar puncture, and normal cerebropinal fluid compoition. REULT: Three children with peudotumor cerebri preented with vertical diplopia and clinical ign of fourth cranial nerve paly including a hypertropia of the affected eye, which increaed with adduction and ipilateral head tilt. The fourth cranial nerve paly reolved after reduction of the intracranial preure in all three children. CONCLUION: Fourth cranial nerve paly may occur in children with peudotumor cerebri and may be a nonpecific ign of elevated intracranial preure.