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Ocular tilt reaction, internuclear ophthalmoplegia, and torsional nystagmus following mitral commissurotomy.
Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus 2012 October
Ocular tilt reaction, a type of skew deviation, and unilateral internuclear ophthalmoplegia with torsional nystagmus resulting from an ischemic event may result from unilateral disruption of otolithic pathways in the medial longitudinal fasciculus. A subset of skew deviations is known to simulate superior oblique palsy; however, none have been reported with a coexisting internuclear ophthalmoplegia. The present report documents the rare occurrence of an ocular tilt reaction simulating a left superior oblique palsy from involvement of left medial longitudinal fasciculus at the level of interstitial nucleus of Cajal.
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