Saccadic Smooth Pursuit and Vestibulo-ocular Reflex Suppression (VORS)

𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 20-yo-man who suffered a left MCA stroke years prior. Upon evaluation of his eye movements, saccades and all classes of eye movements were normal, although his smooth pursuit and VORS were choppy to the left (ipsilesional) and normal to the right. When pursuit and VORS (which are usually either both normal or both abnormal, unless a patient has abnormal smooth pursuit and bilateral vestibular loss (i.e., there is no VOR to suppress) in which case VORS will look better than pursuit) are asymmetric, the choppy movements will be seen in the direction ipsilateral to the side of pathology. Choppy or saccadic smooth pursuit and VORS towards the left, normal to the right. 𝗡𝗲𝘂𝗿𝗼-𝗼𝗽𝗵𝘁𝗵𝗮𝗹𝗺𝗼𝗹𝗼𝗴𝘆 𝗮𝗻𝗱 𝗡𝗲𝘂𝗿𝗼-𝗼𝘁𝗼𝗹𝗼𝗴𝘆 𝗧𝗲𝘅𝘁𝗯𝗼𝗼𝗸 𝗟𝗲𝗴𝗲𝗻𝗱: This is a 20 year-old man who suffered a left middle cerebral artery stroke years prior. Smooth pursuit and VORS were saccadic/choppy in appearance to the left (ipsilesional) and normal to the right. When pursuit and VORS are asymmetrically impaired, the lesion will be ipsilateral to the direction of the eye movement abnormality. https://collections.lib.utah.edu/ ark:/87278/s6j70rkm