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NEUROLOGY 1985;35:725
© 1985 American Academy of Neurology

Alternating skew deviation

47 patients

James R. Keane, MD

Department of Neurology, Los Angeles County-University of Southern California Medical Center, Los Angeles, CA.

Of 408 patients with ocular skew deviation, 47 (12%) had hypertropia that alternated on gaze to either side. Pretectal lesions were responsible for 29 cases, and lower brainstem signs were seen in 5; the site of posterior fossa involvement was uncertain in 13. Acute hydrocephalus, tumors, strokes, and MS were the most frequent causes, followed by spinocerebellar degeneration and tentorial herniation. The mechanism of alternating skew is unknown, but probably involves pathways from both utricles to the vertical-rotatory ocular motor neurons.

Address correspondence and reprint requests to Dr. Keane, 1200 North State Street, Los Angeles, CA 90033.

Presented in part at the thirty-fourth annual meeting of the American Academy of Neurology, Washington, DC, April 25-May 1, 1982.

Accepted for publication August 29, 1984.




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