Environmental Tilt

Environmental Tilt

Environmental tilt, also known as tortopia, is the sensation that visual space is tilted on its side or even upside down ("floor-on-ceiling" phenomenon, "upside-down" reversal of vision, verkehrtsehen). This may last seconds to minutes. The temptation to dismiss such bizarre symptoms as functional should be resisted, since environmental tilt is presumed to reflect damage to connections between cerebellar and central vestibular-otolith pathways. It has been reported in the following situations:

Lateral medullary syndrome of Wallenberg
Transient ischemic attacks in basilar artery territory
Demyelinating disease Head injury Encephalitis
Following third ventriculostomy for hydrocephalus

Cross References

Lateral medullary syndrome; Vertigo; Vestibulo-ocular reflexes