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  • Title: Ocular tilt reaction, internuclear ophthalmoplegia, and torsional nystagmus following mitral commissurotomy.
    Author: Pandey PK, Singh A, Kumar B, Sood S, Kumar S, Kumari E, Chandel M.
    Journal: J AAPOS; 2012 Oct; 16(5):484-6. PubMed ID: 23084391.
    Abstract:
    Ocular tilt reaction, a type of skew deviation, and unilateral internuclear ophthalmoplegia with torsional nystagmus resulting from an ischemic event may result from unilateral disruption of otolithic pathways in the medial longitudinal fasciculus. A subset of skew deviations is known to simulate superior oblique palsy; however, none have been reported with a coexisting internuclear ophthalmoplegia. The present report documents the rare occurrence of an ocular tilt reaction simulating a left superior oblique palsy from involvement of left medial longitudinal fasciculus at the level of interstitial nucleus of Cajal.
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