Ocular tilt reaction resulting from vestibuloacoustic nerve surgery

G. I. Wolfe, C. L. Taylor, Eugene S. Flamm, L. G. Gray, E. C. Raps, S. L. Galetta, J. R. Keane, A. A. Sadun

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

THE OCULAR TILT reaction (OTR) is a triad of head-eye synkinesis composed of head tilt, conjugate ocular torsion in the direction of head tilt, and skew deviation. The OTR represents a normal compensatory response to lateral head tilts and is produced by activation of the utricle of the lowermost ear. A pathological OTR results when otolith activity is unopposed as the result of injury to the opposite utricle or its nerve. Vertical diplopia may be the only symptom of OTR in patients who have undergone surgery involving the vestibuloacoustic nerve. We report a series of patients with OTR after surgery for acoustic neuroma or Meniere's disease. In each patient, the manifesting symptom was vertical diplopia. Bedside neuro-ophthalmological testing readily excluded a brain stem cause for the double vision. We conclude that OTR after vestibuloacoustic surgery is a benign condition with spontaneous resolution of symptoms within several months.

Original languageEnglish (US)
Pages (from-to)417-421
Number of pages5
JournalNeurosurgery
Volume32
Issue number3
StatePublished - 1993
Externally publishedYes

Fingerprint

Diplopia
Saccule and Utricle
Head
Synkinesis
Ocular Motility Disorders
Otolithic Membrane
Meniere Disease
Acoustic Neuroma
Brain Stem
Ear
Wounds and Injuries

Keywords

  • Acoustic neuroma
  • Meniere's disease
  • Ocular tilt reaction
  • Skew deviation
  • Utricle
  • Vestibular nerve

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Wolfe, G. I., Taylor, C. L., Flamm, E. S., Gray, L. G., Raps, E. C., Galetta, S. L., ... Sadun, A. A. (1993). Ocular tilt reaction resulting from vestibuloacoustic nerve surgery. Neurosurgery, 32(3), 417-421.

Ocular tilt reaction resulting from vestibuloacoustic nerve surgery. / Wolfe, G. I.; Taylor, C. L.; Flamm, Eugene S.; Gray, L. G.; Raps, E. C.; Galetta, S. L.; Keane, J. R.; Sadun, A. A.

In: Neurosurgery, Vol. 32, No. 3, 1993, p. 417-421.

Research output: Contribution to journalArticle

Wolfe, GI, Taylor, CL, Flamm, ES, Gray, LG, Raps, EC, Galetta, SL, Keane, JR & Sadun, AA 1993, 'Ocular tilt reaction resulting from vestibuloacoustic nerve surgery', Neurosurgery, vol. 32, no. 3, pp. 417-421.
Wolfe GI, Taylor CL, Flamm ES, Gray LG, Raps EC, Galetta SL et al. Ocular tilt reaction resulting from vestibuloacoustic nerve surgery. Neurosurgery. 1993;32(3):417-421.
Wolfe, G. I. ; Taylor, C. L. ; Flamm, Eugene S. ; Gray, L. G. ; Raps, E. C. ; Galetta, S. L. ; Keane, J. R. ; Sadun, A. A. / Ocular tilt reaction resulting from vestibuloacoustic nerve surgery. In: Neurosurgery. 1993 ; Vol. 32, No. 3. pp. 417-421.
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