Abstract
We describe a case of unilateral paramedian thalamic infarct resulting in Parinaud’s syndrome and an ipsilateral tonic ocular skew deviation. Although two previous cases of phasic ipsiversive ocular tilt reaction (OTR) have been recorded as a result of a unilateral mesodiencephalic lesion, this is the first case in which a tonic skew deviation has been reported to accompany the pretectal syndrome.