生理性眼偏斜反應包括頭位傾斜、眼球共軛旋轉及偏斜視等3 個部份，橢圓囊耳石器、眼外肌、腦幹及小腦均是控制眼偏斜反應的器官，病理性眼偏斜反應則出現於週邊性或中樞性的病灶。本文藉由文獻回顧，提醒臨床醫師對眼偏斜反應的重視，避免把病理性眼偏斜反應誤診為單純的眼肌麻痺、半規管麻痺或斜頸症，不要忽略對橢圓囊耳石器及中樞神經性病灶的診斷，文末並歸納為一個流程，包括眼科斜視檢查、耳神經學檢查及影像學檢查等，可以提供追查病灶時的線索。

The physiologic ocular tilt reaction (OTR) consists of head tilt, biocular conjugate torsion,and skew deviation. The utricle otolith, external ocular skew muscles, brainstem, and cerebellumcollectively mediate it. Peripheral and central lesions lead to pathological OTR. The aim of thepaper is to informclinicians of the importance of OTR,which should not be misdiagnosed as ocularmuscle palsy, semicircular canal palsy, or torticollis when peripheral or central lesions areconsidered. Ophthalmologic strabismus exams, otoneurology, and imaging studies are helpful infinding these lesions. Finally, a flow sheet is included.