Vertical eye deviation in hypoxic coma is considered to be rare. In contrast, we found that in a consecutive series of 50 postresuscitation comatose patients, 28 (56.0%)developed tonic upward or downward eye deviation. We suggest that bo th the upward and the downward deviations resulted from diffuse cerebrocerebella r damage sparing the brainstem. Upward deviation is an early sign, whereas downw ard deviation appears later and generally implies a transition to the vegetative state. In contrast, we found that in a consecutive series of 50 postresuscitation comatose patients, 28 (56.0%) developed tonic upward or downward eye deviation. We suggest that bo th the upward and the downward deviations resulted from diffuse cerebrocerebella r damage sparing the brainstem. Upward deviation is an early sign, compared to downw ard deviation appears later and generally implies a transition to the vegetative state.