I had that problem on my first go-through - turns out, if you edit the config file to leave out mouse float/smoothing, the controls turn as crisp and clear as you could like. (Mouse float is one of those theoretically wonderful ideas with absolute shit real-life implementations.)
(Oh, yeah, and turn of Ubersampling. It’s gorgeous, but you’ll confuse the game for a slideshow unless you’ve got the Monolith from 2001: A Space Odyssey.)