Ocular Motor Signs of Cerebellar Ataxia - Gaze-Evoked Nystagmus, Saccadic Pursuit, and VOR Supression
Alternative Title
Video 4.42 Gaze-evoked and rebound nystagmus, saccadic pursuit and vestibulo-ocular reflex suppression (VORS) in a cerebellar degeneration from Neuro-Ophthalmology and Neuro-Otology Textbook
Creator
Daniel R. Gold, DO
Affiliation
(DRG) Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland
𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 30-year-old woman with a several year long history of imbalance due to cerebellar ataxia of unclear etiology. Seen in this video are common ocular motor signs in patients with advanced cerebellar dysfunction including: 1) saccadic smooth pursuit, 2) saccadic vestibulo-ocular reflex suppression (VORS, a combined eye-head movement; the fact that pursuit and VORS appear to be equally saccadic also tells the examiner that the VOR is present - i.e., if VORS was normal/near-normal appearing but pursuit was saccadic, this would imply that there is no VOR to suppress), 3) gaze-evoked and rebound nystagmus 𝗡𝗲𝘂𝗿𝗼-𝗼𝗽𝗵𝘁𝗵𝗮𝗹𝗺𝗼𝗹𝗼𝗴𝘆 𝗮𝗻𝗱 𝗡𝗲𝘂𝗿𝗼-𝗼𝘁𝗼𝗹𝗼𝗴𝘆 𝗧𝗲𝘅𝘁𝗯𝗼𝗼𝗸 𝗟𝗲𝗴𝗲𝗻𝗱: This patient experienced a several year long history of imbalance due to cerebellar ataxia of unclear etiology. Seen in this video are common ocular motor signs in patients with advanced cerebellar dysfunction including: 1) saccadic smooth pursuit, 2) saccadic VORS (a combined eye-head movement; the fact that pursuit and VORS appear to be equally saccadic also tells the examiner that the VOR is present - i.e., if VORS was normal/ near-normal appearing but pursuit was saccadic, this would imply that there is no VOR to suppress), 3) gaze-evoked and rebound nystagmus. https:// collections.lib.utah.edu/ark:/87278/s6907ch7
