6533b85afe1ef96bd12b979a

RESEARCH PRODUCT

Ocular tilt reaction: a clinical sign of cerebellar infarctions?

subject

description

Ocular tilt reaction (OTR) consists of head tilt, ocular torsion (OT), and skew deviation (SKD) combined with perceptual tilts such as deviations of the subjective visual vertical (SVV). Few case reports have shown that OTR also occurs in patients with cerebellar infarctions.1–4 However, no systematic clinical studies are available on the frequency of signs of OTR in patients with cerebellar lesions. Therefore, the questions arose as to whether OTR is a common clinical sign of an acute cerebellar lesion and whether the time course of its components is similar to those from brainstem infarctions. The cerebellar structures involved in 31 patients were studied in detail elsewhere.5 ### Methods. All 56 patients with acute unilateral cerebellar infarctions (51 ischemic; 5 hemorrhagic) admitted at our department were included in the study (median age 65 years, range 37–84 years; 37 men and 19 women). Forty-three patients had unilateral, and 13 patients with unilateral cerebellar infarctions had additional brainstem lesions (27 patients had right-sided, 29 left-sided lesions). All patients underwent a neuro-ophthalmologic examination including testing tilt of SVV, OT, SKD (for details, see the video5), electronystagmography including caloric irrigation, and MRI scanning. Only two of the patients with infarctions in the territory of the anterior inferior cerebellar artery showed a unilateral hyporesponsiveness in …