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Title | Description | Type |
151 |
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Gaze-Evoked and Centripetal Nystagmus in Creutzfeldt-Jakob Disease | This is a 65-year-old woman who experienced a progressive cerebellopathy over several months. Initially, she presented with mild gait imbalance and positional vertigo, and there was only apogeotropic positional nystagmus (more pronounced in supine roll test compared to Dix-Hallpike) with a very slig... | Image/MovingImage |
152 |
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Gaze-evoked and Rebound Nystagmus in a Cerebellar Syndrome | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: 30-yo-man with the subacute onset of a cerebellar syndrome. After extensive evaluation and progression, it was thought that this represented an autoimmune process and there was some improvement with immunosuppression. He ... | Image/MovingImage |
153 |
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Gaze-Evoked Nystagmus & Slow Saccades Due to Anti-GAD Antibodies in a Patient with Stiff Person Syndrome | This is a 70-year-old woman with a several year long history of imbalance and stiffness. Exam demonstrated axial and lower extremity stiffness, and ocular motor exam demonstrated gaze-evoked nystagmus (e.g., right-beating in right gaze, left-beating in left gaze, up-beating in up gaze), and mild to ... | Image/MovingImage |
154 |
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Gaze-Evoked, Rebound, and Centripetal Nystagmus in Cerebellar Degeneration | A 68-year-old female reported a 2-year history of progressive gait imbalance, falls, dizziness and vertical oscillopsia. She described that dizziness and oscillopsia were worst when looking down. There was no family history of ataxia. Composite gaze with fixation was recorded with video-oculography ... | Image/MovingImage |
155 |
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The Geotropic Variant of Horizontal Canal BPPV | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a patient with the geotropic (nystagmus beating towards the ground) variant of left horizontal canal (HC) benign paroxysmal positional vertigo (BPPV). In a patient with geotropic (nystagmus beating towards the gro... | Image/MovingImage |
156 |
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Gufoni Maneuver for Left Horizontal Canal BPPV, Canalithiasis (Geotropic Nystagmus) | The Gufoni maneuver may be preferable to the BBQ roll, as the Gufoni maneuver does not require the individual to roll or be in a prone position, making the maneuver more feasible to complete for individuals who are elderly, obese and/or experience immobility. Antecedently, some clinicians remember t... | Text |
157 |
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Gufoni Maneuver for Left Horizontal Canal BPPV, Canalithiasis (Geotropic Nystagmus) (Video) | The Gufoni maneuver may be preferable to the BBQ roll, as the Gufoni maneuver does not require the individual to roll or be in a prone position, making the maneuver more feasible to complete for individuals who are elderly, obese and/or experience immobility. Antecedently, some clinicians remember t... | Image/MovingImage |
158 |
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Gufoni Maneuver for Right Horizontal Canal-Cupulolithiasis (Apgeotropic Nystagmus) | The Gufoni Maneuver can be used to treat horizontal canal cupulolithaisis. 1. The patient starts in a seated position. 2. The patient transitions quickly to lying on their affected side. 3. The patient lies on their affected side for two minutes with the head in a neutral position. 4. The patient's ... | Text |
159 |
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Gufoni Maneuver for Right Horizontal Canal-Cupulolithiasis (Apgeotropic Nystagmus) (Video) | The Gufoni Maneuver can be used to treat horizontal canal cupulolithaisis. 1. The patient starts in a seated position. 2. The patient transitions quickly to lying on their affected side. 3. The patient lies on their affected side for two minutes with the head in a neutral position. 4. The patient's ... | Image/MovingImage |
160 |
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Head Movement Independent ('Sitting') Oscillopsia - A Common Symptom of Nystagmus and Saccadic Intrusions/Oscillations | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This video is an example of what a patient with spontaneous nystagmus or saccadic intrusions/oscillations experiences visually during the abnormal eye movements - i.e., oscillopsia (illusion of movement of the stationary ... | Image/MovingImage |
161 |
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Head-Shaking (2-3 Hz) | Head-shaking: instruct the patient to close their eyes and perform active rapid head-shaking at 2-3 Hz for ~15 secs. If a unilateral vestibulopathy is present, head-shaking-induced (contralesional) nystagmus is often provoked, with the slow phase toward the affected ear. With central lesions, the ny... | Image/MovingImage |
162 |
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Head-Shaking Nystagmus | Head-shaking nystagmus: With a peripheral lesion, similar to vibration, transiently accentuates vestibular asymmetry when baseline VOR function is asymmetric, central patterns are well described and have localizing value (e.g., causing vertical nystagmus after horizontal head-shaking, horizontal nys... | Image/MovingImage |
163 |
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Head-Shaking Nystagmus - A 'Central' Pattern | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: Evaluating for nystagmus provoked by head-shaking, so-called head-shaking nystagmus (HSN), should be performed in all patients with complaints of dizziness or vertigo, regardless of the chronicity. The maneuver is perform... | Image/MovingImage |
164 |
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Head-Shaking-Induced Nystagmus Following Ramsay Hunt Vestibulopathy | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 50-year-old man who experienced the abrupt onset of imbalance, dizziness and left-sided hearing loss 4 months prior to this examination. He was found to have herpetic vesicles in the left external auditory canal... | Image/MovingImage |
165 |
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Hemifacial Spasm | This is a 45-year-old man with intermittent left facial twitching and eyelid closure for the last 6 months. With observation, spontaneous left facial spasms were seen involving the orbicularis oculi and oris muscles. With voluntary contraction of left facial muscles, with smiling for instance, there... | Image/MovingImage |
166 |
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HINTS 'Plus' Patterns in the Acute Vestibular Syndrome Based on Location | HINTS ‘Plus' patterns in the acute vestibular syndrome based on location | Text |
167 |
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HINTS (Head Impulse Nystagmus Test of Skew) Exam | The HINTS "Plus" examination is used to evaluate patients with the acute vestibular syndrome (AVS), an acute onset of continuous vertigo or dizziness, nausea, and vomiting with nystagmus. A head impulse test is performed to evaluate function of cranial nerve 8. The patient is asked to look at a targ... | Image/MovingImage |
168 |
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HINTS Exam and Saccadic Dysmetria in Lateral Medullary Stroke | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 50-year-old who experienced the abrupt onset of prolonged vertigo following chiropractic therapy 2 months prior. Initial work-up included an MRI and MR angiogram - MR-diffusion weighted imaging showed an acute l... | Image/MovingImage |
169 |
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Horizontal Canal - BPPV: BBQ Roll to Treat the Right Side | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: To treat right horizontal canal (HC)-BPPV (each position maintained for at least 30 seconds or until nystagmus and/or vertigo cease): • First the patient is placed in the long-sitting position • Then in a supine posit... | Image/MovingImage |
170 |
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Horizontal Canal - BPPV: Gufoni for Right Apogeotropic | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: To treat the right apogeotropic (beating towards the sky with right ear down and with left ear down - e.g., left beating nystagmus with right supine roll test or with right ear down; right beating nystagmus with left supi... | Image/MovingImage |
171 |
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Horizontal Gaze Palsy, Facial Nerve Palsy, and Nystagmus Due to Dorsal Pontine Ischemia | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: Presented here are two patients with horizontal gaze and facial palsies due to stroke. The first patient is a 60-year-old man who presented with double vision and hemiparesis due to a right dorsal pontine ischemic stroke.... | Image/MovingImage |
172 |
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Horner's Syndrome with Anhidrosis | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a patient with the onset of ptosis OD years prior, with clear evidence of a Horner's syndrome. Imaging of the oculosympathetic tract was unrevealing. The patient also mentioned that with exercise, the left side of... | Image/MovingImage |
173 |
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How to Measure Ocular Alignment Virtually | Ocular alignment: the alternate cover test can be performed by instructing the patient to hold their head steady, fix their eyes on the camera (or a more distant target - the closer the fixation target, the more of an exodeviation the examiner will see), and use their cell phone (or a spoon) to occl... | Image/MovingImage |
174 |
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Hyperventilation | Hyperventilation: instruct the patient to breathe rapidly in and out of their mouth for 40-60 seconds. Alkalosis and changes in ionized calcium may improve conduction through an affected segment of 8th cranial nerve due to vestibular schwannoma (https://collections.lib.utah.edu/details?id=1213447) o... | Image/MovingImage |
175 |
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Hyperventilation-Induced Downbeat Nystagmus in a Cerebellar Disorder | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 45-year-old woman with a chronic progressive cerebellopathy of unclear etiology (worsening over at least 10 years) characterized by gait and limb ataxia, gaze-evoked nystagmus, saccadic pursuit and vestibulo-ocu... | Image/MovingImage |