Revisión sobre la desviación oblicua

Abstract

Introduction: Skew deviation is a lack of vertical alignment of the eyes that cannot be explained as a result of paralysis of the eye muscles. We will review the pathophysiology of this syndrome, its clinical expressivity and how to diagnose it. Methods: Narrative review. Results: The skew deviation is the result of a lesion in the vestibular-ocular neural pathway. Being a cross-way, depending on where the pathology is located, the lack of ocular alignment can affect one or the other eyeball. In both peripheral and central lesions, it can be accompanied by lateral tilt of the head and ocular torsion, which determines the triad known as "ocular-cephalic tilt reaction". For the diagnosis of the skew deviation, in addition to the observation we will use the "cover test" and the rod of Maddox. Discussion: Although the physiopathology of these clinical manifestations is very interesting, it is an infrequent process, still to be understood and with little locator value. Conclusion: Skew deviation always requires discarding, through imaging tests, central neurological pathology. In the context of acute vertigo, it may be the only indicator of involvement of the Central Nervous System.