Cerebellar skew deviation and the torsional vestibuloocular reflex.

Content Provider	Semantic Scholar
Author	Wong, Agnes M. F. Sharpe, James A.
Copyright Year	2005
Abstract	BACKGROUND Skew deviation is typically caused by brainstem damage, and has not been identified with focal cerebellar lesions. This vertical strabismus has been attributed to asymmetric disruption of vestibuloocular reflex (VOR) projections from otolithic receptors of the utricle to ocular motoneurons, but asymmetry of the utriculo-ocular counter-roll reflex has not been detected. METHODS Lesions localized to the cerebellum were identified by MRI in five patients with vertical strabismus. Their skew deviation was measured by prism cover tests in all patients and by search coils in three patients. The angular VOR was tested in patients and 10 controls during sinusoidal +/- 10 degree torsional, vertical, and horizontal head-on-body rotations at 0.5, 1, and 2 Hz. Static torsional VOR gain was measured by the change in torsional eye position divided by change in head position during maintained head tilt. RESULTS Static torsional VOR gains were asymmetric in each patient. Three patterns of asymmetry were identified: 1) decreased static gain in one eye in both directions; 2) decreased gains in both eyes in one direction; and 3) asymmetric gain in one direction in one eye alone. Dynamic torsional VOR gains were symmetrically reduced in both directions in both eyes in all patients. CONCLUSIONS Focal cerebellar lesions can cause skew deviation. The static torsional vestibuloocular reflex (VOR) is linked to cerebellar control of vertical vergence. Asymmetry between the eyes or in direction of the static torsional VOR provides evidence that monocular or binocular imbalance of the utriculo-ocular reflex leads to cerebellar skew deviation.
Starting Page	15829
Ending Page	15834
Page Count	6
File Format	PDF HTM / HTML
Alternate Webpage(s)	http://individual.utoronto.ca/agneswong/Wongpublications/Wong_2005-Cerebellar_Skew_Deviation.pdf
Alternate Webpage(s)	http://www.eyeresearch.ca/sites/default/files/journals/Wong_2005-Cerebellar_Skew_Deviation.pdf
PubMed reference number	16087906v1
Volume Number	65
Issue Number	3
Journal	Neurology
Language	English
Access Restriction	Open
Subject Keyword	3-methyl-2-oxobutanoate dehydrogenase (ferredoxin) activity Acoustic Evoked Brain Stem Potentials Cerebellar lesions Cortical Cell Layer of the Cerebellum Eye Gain Hertz (Hz) Patients Projection Defense Mechanism Reflex action Reflex, Vestibulo-Ocular Structure of both eyes Utricle structure
Content Type	Text
Resource Type	Article