Skew deviation [Skew deviation]

Details

Serval ID
serval:BIB_9608B682D5C6
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Skew deviation [Skew deviation]
Journal
Klinische Monatsblätter für Augenheilkunde
Author(s)
Borruat F.X., Gianoli F., Maeder P., Bogousslavsky J.
ISSN
0023-2165
Publication state
Published
Issued date
1998
Peer-reviewed
Oui
Volume
212
Number
5
Pages
289-90
Language
french
Notes
Publication types: English Abstract ; Journal Article - Publication Status: ppublish
Abstract
BACKGROUND: Skew deviation is a vertical ocular misalignment of prenuclear origin. Although well described in the literature, it is still probably underdiagnosed. Natural history of skew deviation is not well described in the literature. PURPOSE: To describe the clinical presentations, etiologies and follow-up of skew deviation. METHODS: Retrospective study of 29 patients diagnosed with skew deviation between 1993 and 1996. RESULTS: The commonest cause was cerebrovascular accident (12/29) and the commonest localisation was mesencephalic (9/29). Other causes included surgery (7/29), tumor (4/29), trauma (3/29), degeneration (3/29), inflammatory (2/29), increased intracranial pressure (1/29). Other localisations included cerebellum (5/29), ponto-mesencephalic (3/29), and medulla (2/29). Vertical diplopia was always accompanied by other neuro-ophthalmologic abnormalities. 69.2% (18/26) patients were totally asymptomatic after 7.5 months. 30.8% (8/26) were still symptomatic (diplopia). One patient required surgery, three patients were relieved with prisms, one patient needed monocular occlusion. One patient died during follow-up and precise data were lacking in two symptomatic patients. CONCLUSION: Skew deviation is not so rare, 10% of the cases referred to us for diplopia in 3 years. The diagnosis of skew deviation should be entertained when vertical diplopia cannot be explained by pathology of extraocular muscles, peripheral or central cranial nerve III or IV palsies, myasthenia, or orbital pathology. Prognosis for recovery in patients with skew deviation is good. 70% will recover, after a median time of 7.5 months. Surgery should be postponed at least for 12 months.
Keywords
Adolescent, Adult, Aged, Aged, 80 and over, Brain Stem, Child, Diplopia, Female, Fixation, Ocular, Follow-Up Studies, Humans, Male, Middle Aged, Oculomotor Nerve, Retrospective Studies, Strabismus
Pubmed
Web of science
Create date
11/04/2008 8:23
Last modification date
20/08/2019 14:58
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