| Identifier |
Oculogyric_crisis |
| Title |
Oculogyric Crisis |
| Creator |
Andrew G. Lee, MD; Daniel Bailey |
| Affiliation |
(AGL) Chairman, Department of Ophthalmology, The Methodist Hospital, Houston, Texas; Professor of Ophthalmology, Weill Cornell Medicine, New York City, New York; (DB) Class of 2021, Baylor College of Medicine, Houston, Texas |
| Subject |
Dystonia; Neuroleptics; Diagnosis; Oculogyric |
| Description |
Dr. Lee lectures medical students on oculogyric crisis. |
| Transcript |
So, today we're going to talk about oculogyric crisis. Oculo (the eyes) gyrate (turn) and it looks like a crisis because it occurs acutely. And so, what we have is tonic elevation of the eyes upward, although they can deviate upward and laterally, or in rare cases downward. So, it's tonic, it's bilateral, it's conjugate, and it's usually upward. And oculogyric crisis can be a dystonic reaction after medicines, including neuroleptics of various types, but also things that an ophthalmologist might see, like metoclopramide, which is used for nausea and vomiting. Other medicines can cause it, and so if you see it you really should be looking up the list and make sure your patient hasn't been exposed to one of these medicines that can cause it. In patients who are in oculogyric crisis, they might have disordered thinking, agitation, restlessness. They might have other automatisms and they might stiffen up and they might roll backwards like this-opisthotonos, we call that. So, it's a dystonic reaction that causes the eyes to gyrate upward and tonically. In addition, you need to work it up because there are other things that can cause it. So normally, we would do an EEG to look for seizure activity. And rarely, intracranial lesions are associated with it and so an MRI scan, especially looking at the thalamo-mesencephalic junction. So, for the tonic up-gaze version of it, we're going to be looking at the vertical gaze center. And the down-gaze form, that could be like hydrocephalus or hemorrhages at the level of the thalamo-mesencephalic junction. So oculogyric crisis: oculo (the eyes) gyrate (turn up). Acute, tonic, bilateral, conjugate, involuntary, and upward. They may or may not have other symptoms and signs. It's a dystonic reaction to medicines. Do an EEG to make sure it's not a seizure. Do an MRI scan to make sure there's no structural lesion. And ophthalmologists need to know about it and the medicine lists that can cause it. |
| Date |
2020-05-27 |
| Language |
eng |
| Format |
video/mp4 |
| Type |
Image/MovingImage |
| Collection |
Neuro-Ophthalmology Virtual Education Library: Andrew G. Lee Collection: https://novel.utah.edu/Lee/ |
| Publisher |
North American Neuro-Ophthalmology Society |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah |
| Rights Management |
Copyright 2019. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s69d2bf5 |
| Setname |
ehsl_novel_lee |
| ID |
1561513 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s69d2bf5 |
