An Efficacy of Head Tilt Test in the Patients with Unilateral Superior Oblique Palsy.

Kim, Ji Taek; Kim, Dong Seob; Shin, Jung Chul

Original Article

Journal of the Korean Ophthalmological Society 1998;39(11):2789-2796.
Published online November 1, 1998.

An Efficacy of Head Tilt Test in the Patients with Unilateral Superior Oblique Palsy.

Ji Taek Kim, Dong Seob Kim, Jung Chul Shin

Department of Ophthalmology, College of medicine, Hanyang University Hospital.

단안 상사근 마비 환자에서 머리 기울임 검사의 유용성

김지택(Ji Taek Kim),김동섭(Dong Seob Kim),신정철(Jung Chul Shin)

Abstract

Head tilt test is useful in diagnosing cyclovertical muscle palsy, especially superior oblique palsy, In this study, we observed efficacy and pattern of head tilt test in 12 patients of unilateral superior oblique palsy(7 congenital, 4 traumatic and 1 vascular) who had abnormal head tilt to nonparetic side. The results of head tilt test were compared to preoperative status in 8 patient, 3 month after surgery. All patients in this study showed positive response of head tilt test. Among them, 9 patients showed definite elevation of paretic eye. However, 2 patients mainly showed definite depression of nonparetic eyes that were amblyopic. The last patient did not show definite vertical deviation in either eye but complained of increasing diplopia. After surgery, abnormal head tilt and positive head tilt response disappeared in 7 patients. In conclusion, preoperative head tilt test is one of the valuable methods in diagnosisng unilateral superior oblique palsy especially in young patients and in those who developed spread of comitance. In addition, the positive head tilt test does no always mean the elevation of paretic eye.

Key Words: Abnormal head tilt;Head tilt test;Superior oblique palsy