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Herman C. Sullivan, MD; Henry J. Kaminski, MD; Eric F. Maas, MD; Joseph D. Weissman, MD, PhD; R. John Leigh, MD

Arch Neurol. 1991;48(3):310-311.

Abstract
• We examined 35 patients with unilateral cerebral lesions to determine the incidence of lateral deviation of the eyes under forcefully closed lids and the reliability of this sign in predicting the side of the lesion. Only patients with radiologically confirmed unilateral lesions were studied. Over 70% of patients had contralateral ocular deviation (Cogan's "spasticity of conjugate gaze"), 20% had ipsilateral deviation, and less than 9% of the patients had no deviation. Lateral ocular deviation was as sensitive, but not as specific, as a unilateral Babinski plantar response in determining the side with the lesion. Contralateral deviation was more common with parietotemporal localization, suggesting that the phenomenon reflects an underlying disturbance of attentional mechanisms.

Author Affiliations
From the Departments of Neurology, University Hospitals of Cleveland, Cleveland Veterans Administration Medical Center, and Cleveland MetroHealth Center, Case Western Reserve University, Ohio. Dr Sullivan is presently with the Department of Neurology, Stanford (Calif) University Medical Center, and Dr Weissman with the Department of Neurology, Emory University, Atlanta, Ga.

Footnotes
Accepted for publication August 27, 1990.

Reprint requests to Department of Neurology, University Hospitals of Cleveland, 2074 Abington Rd, Cleveland, OH 44106 (Dr Leigh).

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