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Anterior plagiocephaly due to unicoronal craniosynostosis is commonly associated with an ipsilateral hypertropia and a contralateral head tilt. The ipsilateral superior oblique weakness has been attributed to the shortening of the orbital roof with retroplacement of the trochlea, and to heterotopic positioning of the vertical rectus muscles within the orbit. These anatomical aberrations may alter ocular rotations to mimic a true congenital superior oblique palsy. This paper describes two siblings with synostotic plagiocephaly and simulated superior oblique palsy with ocular torticollis successfully managed by strabismus surgery. Synostotic plagiocephaly should be included in the differential diagnosis of familial congenital superior oblique palsy. [ABSTRACT FROM AUTHOR]

Aims: To evaluate, by means of electronic baropodometry (EB), the postural findings in patients affected by ocular torticollis. Methods: Posturographic analysis (length of the sway path, sway area, and mean velocity) was made in 54 patients with IV palsy, Duane Syndrome, or rectus superior palsy (group A) and compared with a control group of 45 healthy subjects (group B). The test was performed with both eyes open, then both closed, then with the affected eye open, and finally with the healthy eye open. Results: With both eyes open or closed, the length of the sway path, the sway area, and mean velocity were significantly increased in group A compared with group B ( P<0.0001). When the open eye was the one with the muscular paresis, the length of the sway path was significantly increased as compared with the healthy eye ( P<0.0001), and the sway area was increased too ( P<0.029). No statistical differences were observed mean velocity according to which eye was open ( P==NS). Conclusions: EB is a useful instrument for studying secondary postural anomalies in patients affected by OT. [ABSTRACT FROM AUTHOR]