The Role of Neuro-Ophthalmology in Atypical Parkinsonism: Clinical Findings on a Standardized Ocular Motor Exam

Parkinsonian disorders can be divided into idiopathic Parkinson's disease and atypical parkinsonism, including progressive; supranuclear palsy (PSP), multisystem atrophy (MSA), dementia with Lewy bodies (DLB), and corticobasal syndrome (CBS).; Diagnostic challenges include phenotypic overlap and delayed development of classic features, making early diagnosis difficult. Eye movement exam may assist with diagnosis, particularly early when findings are subtle. For example, supranuclear gaze palsy (SGP) of PSP demonstrates absent optokinetic fast phases as the earliest manifestation; downbeat nystagmus may indicate MSA; and ocular motor apraxia (OMA)/Balint syndrome may indicate CBS or DLB. The aim of this study was to categorize findings of a standardized clinical ocular motor examination in atypical parkinsonism.