Vertical ocular motility disturbance in pseudotumor cerebri

Three patients with pseudotumor cerebri developed transient vertical ocular motor abnormalities. All had associated sixth nerve palsies and two had significant abnormalities of visual acuity and fields. Effective treatment of elevated intracranial pressure (ICP) resulted in resolution of the motility disturbance in all cases. This unusual oculomotor feature of elevated ICP may be due to skew deviation or fourth nerve palsy, but in either instance it is not a localizing sign.