Skew deviation syndrome (hertwig-magendie syndrome) 1

General: Vascular deficiency involving the brains 242e42c tem and middle cerebral peduncle; observed after encephalitis, tumors of the cerebellum, and lesions of the labyrinth; this is a vertical strabismus due to a supranuclear lesion; bilateral and alternating skew deviation suggests midbrain or caudal medullar lesion.

Ocular: Alternating paresis of elevators of one eye combined with depressor paresis of the other eye or alternating hyperphorias; in skew deviation the eyes point in diagonally opposite directions; this effect is more pronounced in the eye contralateral to the lesion.

Clinical: Cerebellar ataxia.

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Moster ML, et al. Alternating skew deviation on lateral gaze (bilateral abducting hypertropic). Ann Neurol 1988; 23:190.

Silfverskiold BP. Skew deviation in Wallersberg's syndrome. Acta Neurol Scand 1966; 41:381.