Delayed Trochlear Nerve Palsy in a Case of Zoster Oticus

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Abstract
A 57-year-old man with herpes zoster oticus developed a delayed fourth nerve palsy followed by transient intermittent sixth nerve weakness. Trochlear nerve lesions occur rarely with zoster, particularly in the absence of zoster ophthalmicus. A knowledge of the wide range of motor manifestations and the chronicity of meningitis with zoster will afford earlier diagnosis without resort to arteriography.