Ocular Motor Signs in Early Progressive Supranuclear Palsy

Update item information
Identifier Ocular_motor_signs_in_early_PSP
Title Ocular Motor Signs in Early Progressive Supranuclear Palsy
Subject Abnormal Saccades; Abnormal Convergence; Abnormal Pursuit; Abnormal Range; Abnormal VORS; Vertical Gaze Palsy; Downgaze Palsy; OMS Mesencephalon
Creator Roksolyana Tourkevich, MD, Department of Neurology, The Johns Hopkins School of Medicine; Tony Brune, DO, Department of Neurology, The Johns Hopkins School of Medicine; Daniel R. Gold, DO, Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine
Description This is a 64-year old man who experienced imbalance and falls (usually backwards) for the last 6 months. He experienced difficulty navigating stairs and had become a messy eater (thought to be in large part due to his vertical gaze palsy), and had developed hypophonia. Exam demonstrated square wave jerks, supranuclear downward>upward palsy (i.e., improved with the vertical vestibulo-ocular reflex [VOR]), slow and hypometric horizontal saccades with very slow down>up saccades (especially apparent with optokinetic tape), convergence insufficiency, and saccadic smooth pursuit and VOR suppression. ; While a supranuclear vertical gaze palsy is the most sought after ocular motor finding when progressive supranuclear palsy (PSP) is being considered, other ocular motor abnormalities are commonly seen as well and include all of those listed above and seen in the video. Since upgaze can become impaired to some degree with normal aging (whether this is related to changes involving the orbital tissues or whether this is in part supranuclear is not clear), poor downgaze in a patient with a gait/balance disorder is more diagnostically meaningful.
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2017-12
Type Image/MovingImage
Format video/mp4
Relation is Part of NOVEL: Neuro-ophthalmology Virtual Education Library Examination Collection
Rights Management Copyright 2018. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E, SLC, UT 84112-5890
Collection Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
Language eng
ARK ark:/87278/s6gr0vxw
Setname ehsl_novel_gold
Date Created 2018-01-02
Date Modified 2021-05-06
ID 1290930
Reference URL https://collections.lib.utah.edu/ark:/87278/s6gr0vxw