PMID: 9532539Apr 9, 1998Paper

Ocular tilt reaction with vertical eye movement palsy caused by localized unilateral midbrain lesion

Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society
T OhashiH Matsuda

Abstract

A 60-year-old man developed diplopia and experienced difficulty moving his eyes. Vertical movement of each eye, including vestibulo-ocular reflex and smooth pursuit, was extremely limited. Horizontal eye movements were normal. His head position was tilted toward his left. There was 10 prism diopters of exotropia and 10 prism diopters of right hypertropia. Fundus photographs revealed a clockwise torsion of both eyes. These signs indicate leftward ocular tilt reaction. Magnetic resonance imaging showed a small area of an increased signal intensity localized in the midbrain dorsomedial to the red nucleus on the right side. Based on recent experimental evidence, it may be assumed that the unilateral lesion involving the right interstitial nucleus of Cajal most probably caused leftward ocular tilt reaction in our patient.

Citations

Jan 9, 2003·Surgical Neurology·Hidekatsu Mizushima, Tamotsu Seki
Jan 4, 2006·NeuroRx : the Journal of the American Society for Experimental NeuroTherapeutics·Craig Evinger
Feb 28, 2006·Survey of Ophthalmology·Michael C BrodskyThomas Brandt
Oct 14, 2005·Progress in Brain Research·Anja K E Horn
Jan 19, 2007·Journal of Neurophysiology·Farshad FarshadmaneshJ Douglas Crawford
Feb 8, 2000·Current Opinion in Ophthalmology·M F Walker, D S Zee

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