Medical College of Wisconsin
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Torsional eye movements in patients with skew deviation and spasmodic torticollis: responses to static and dynamic head roll. Neurology 1997 Feb;48(2):506-14



Pubmed ID




Scopus ID

2-s2.0-0031033504   48 Citations


We measured torsional eye movements induced by sinusoidal rotation or static tilt, of the head in roll while viewing a far or near target in 4 patients with skew deviation due to brainstem lesions, 4 patients with spasmodic torticollis (ST), 2 patients with unilateral eighth nerve section (VIIIS), and 10 normal subjects. Torsional nystagmus was present in all 4 patients with skew deviation. In subjects and patients, responses to both sinusoidal and static roll were larger while viewing the far target, consistent with factors dictated by geometry. Response gains to sinusoidal roll were abnormal in 3 patients with skew (increased in one, decreased in two), abnormal in 3 with ST (increased in 1, decreased in 2), and in abnormal both VIIIS patients (decreased). Greater abnormalities were evident in 3 skew patients while rolling away from the side of their brainstem lesions and in both VIIIS patients while rolling toward their lesioned ears. There were similar but less pronounced changes during static head roll. We conclude that patients with skew, ST, and VIIIS may all have abnormal ocular counter-rolling that is more evident during dynamic testing while viewing a far target. Such abnormalities endure because of the limited influence exerted by vision on torsional eye movements.

Author List

Averbuch-Heller L, Rottach KG, Zivotofsky AZ, Suarez JI, Pettee AD, Remler BF, Leigh RJ


Bernd F. Remler MD Professor in the Neurology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Brain Diseases
Brain Stem
Eye Movements
Fixation, Ocular
Middle Aged
Reflex, Vestibulo-Ocular
Torsion Abnormality
Vestibule, Labyrinth
Vision Disorders