Vertical, torsional, or oblique diplopia.
Worse on downward gaze and gaze away from affected muscle 
Head-tilt
Tilt typically away from affected side (~70%) to overcome inward rotation of affected eye to create wider separation of images. Can be paradoxical, where patient tilts head toward affected side (~3%)  
Bielschowsky phenomenon - head tilt to affected side reveals inability to intort, diplopia
Worse on downward gaze and gaze away from affected muscle 
Tilt typically away from affected side (~70%) to overcome inward rotation of affected eye to create wider separation of images. Can be paradoxical, where patient tilts head toward affected side (~3%)  
Bielschowsky phenomenon - head tilt to affected side reveals inability to intort, diplopia
Fourth nerve palsy
Increased intracranial pressure 
Third nerve palsy
Vascular:  Stroke, subarachnoid hemorrhage, aneurysm 
Sixth nerve palsy
Neoplastic: Tumor in the subarachnoid space
Ulnar neuropathy
Degenerative/deficiency: Vitamin B12 deficiency, Wernicke-Korsakoff syndrome