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Title | Description | Subject |
26 |
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Atypical Ocular Motor Features (Gaze-evoked Nystagmus) in PSP | This is a 70-yo-woman who met clinical and radiologic diagnostic criteria for progressive supranuclear palsy (PSP). Typical ocular motor features of PSP include square wave jerks, hypometric saccades, choppy pursuit/VORS, impaired down>upgaze (supranuclear in origin) and impaired down>upward saccade... | Abnormal Saccades; OMS Cerebellar; Jerk Nystagmus; Upbeat Nystagmus; Gaze Evoked Nystagmus |
27 |
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Slow Volitional Saccades and Poor Fast Phases to an Optokinetic Stimulus, with Preserved Head Impulse Testing | This is a 67-year-old woman presenting with imbalance and binocular horizontal diplopia at near. On examination there were frequent square wave jerks, limited supraduction OU and convergence insufficiency, which explained her diplopia. Pursuit and suppression of the vestibulo-ocular reflex were sa... | Abnormal Saccades; VOR HIT Normal |
28 |
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Parinaud's Syndrome with Impaired Upward Saccades and Otherwise Normal Vertical Eye Movements | This is a 50-yo-man who suffered a dorsal midbrain stroke. Exam demonstrated normal vertical range of eye movements, normal vertical VOR and smooth pursuit, but inability to perform upward saccades. Another feature of Parinaud's syndrome seen on his exam was light-near dissociation (not shown in thi... | Abnormal Saccades; Range of Eye Movements; Abnormal Range of Eye Movements; Smooth Pursuit; Normal VOR; Dorsal Midbrain Syndrome |
29 |
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Chronic Progressive External Ophthalmoplegia (CPEO) and Cerebellar Signs | This is a 60-yo-woman who initially presented with imbalance and ophthalmoparesis. Initially, there was mild horizontal gaze limitation with mild gaze-evoked nystagmus and slow saccades, and over the years, gait ataxia and dysarthria (mainly a scanning quality to her speech) developed, and her ophth... | Abnormal Saccades; Abnormal Range; Horizontal Gaze Palsy; Gaze Evoked Nystagmus |
30 |
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riMLF Syndrome from Artery of Percheron Stroke | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 65-yo-man who suffered the abrupt onset of loss of consciousness followed by difficulty looking down. MRI showed bilateral rostral midbrain strokes in the distribution of the artery of Percheron. He could not in... | Saccades Abnormal; Vestibulo-ocular Reflex and Head Impulse Testing Normal; Pursuit Normal; Vertical Gaze Palsy; Downgaze Palsy; Mesencephalon |
31 |
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Bilateral riMLF Syndrome Causing Vertical Saccadic Palsy and Loss of Ipsitorsional Fast Phases | This is a 60-year-old man who developed fatigue and diabetes insipidus about 12 months prior to this video, and MRI demonstrated hypothalamic enhancement at that time. Nine months prior to this video, he gradually noticed that he was unable to look down. Work-up for ischemic, infectious, inflammator... | Midbrain OMS; Downgaze Palsy; Upgaze Palsy; Vertical Gaze Palsy; Abnormal Saccades; Normal Pursuit |
32 |
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Parinaud's Syndrome in a Man with GBM of the Pineal Gland | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 60-yo-man who presented with diplopia, headaches, and difficulty looking up, and was found to have a mass involving the pineal gland. Biopsy was diagnostic of a GBM. Major features of Parinaud's (dorsal midbrain... | Saccades; Convergence; Range; Dorsal Midbrain Syndrome; Convergence Retraction Nystagmus; Upgaze Palsy |
33 |
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Convergence | Can bring out or change the direction of vertical nystagmus in Wernicke's, or cerebellar disease; may be impaired in Parkinson's disease, head trauma, elderly patients; may overcome an adduction deficit with an INO. Instructional ocular motor examination procedures. | Convergence; Exam; Abnormal Saccades |
34 |
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Test Your Knowledge - Vertical-Torsional Nystagmus | Question #1: Watch the first portion of the video until you are told to stop. Is this vestibular nystagmus more likely to be peripheral or central? A. Peripheral B. Central Answer for #1: A. Incorrect. While the patient has upbeat-torsional (top poles beating toward the right ear) nystagmus which is... | Jerk Nystagmus; Rotary Nystagmus; Upbeat Nystagmus; INO; Skew; Abnormal Alignment; Abnormal Saccades; Vestibular Nystagmus; Acute Vestibular Syndrome |
35 |
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The Acute Vestibular Syndrome with Dysarthria, Dysphagia, Dysphonia, Hemi-ataxia, and Saccadic Dysmetria Due to the Lateral Medullary (Wallenberg) Syndrome | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 50-year-old woman with the acute onset of vertigo, dysarthria, dysphagia and dysphonia/hoarseness (nucleus ambiguus), ptosis and imbalance. Her examination localized to a left lateral medullary (Wallenberg) synd... | Acute Vestibular Syndrome; Ninth Nerve; OMS Medulla; Abnormal Saccades; Tenth Nerve; Lateropulsion; Horner Syndrome |
36 |
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Cerebellar Eye Signs in SCA8 | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 30-yo-man with a diagnosis of SCA 8 who had appendicular and gait ataxia in addition to choppy smooth pursuit and VORS, downbeat nystagmus, saccadic hypermetria, and gaze-evoked nystagmus with rebound nystagmus.... | Saccadic Dysmetria; Downbeat Nystagmus; Gaze-evoked Nystagmus; Vestibulo-ocular Reflex (VOR) Supression; Saccades |
37 |
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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... | Abnormal Saccades; Acute Vestibular Syndrome; Jerk Nystagmus; Vestibular Nystagmus; Normal VOR; Skew Deviation; OMS Medulla |
38 |
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Saccades | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: The examiner should note: conjugacy (a lag of the adducting eye may be seen with an INO); accuracy (posterior fossa lesions commonly produce dysmetria (overshooting or undershooting); velocity (if slow, may suggest a lesi... | Saccades; Exam; Conjugacy; Abnormal Saccades |
39 |
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Test Your Knowledge - Vertical Saccadic Palsy Due to Bilateral riMLF Infarctions | This is a 30-year-old who was found minimally responsive on the lounge floor of an ice skating rink. He was brought to the ED, where he had a GCS score of 8 (where 15 is normal) for poor responsiveness. His ocular motor exam is shown in the video. Regarding Finding #1, which of the following is fals... | Abnormal Saccades; Normal Optokinetic; Abnormal Range; Vertical Gaze Palsy; Upgaze Palsy; Downgaze Palsy; Mesencephalon; Ocular Motor |
40 |
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Ocular Motor Signs in Early Progressive Supranuclear Palsy | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 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 ver... | Abnormal Saccades; Abnormal Convergence; Abnormal Pursuit; Abnormal Range; Abnormal VORS; Vertical Gaze Palsy; Downgaze Palsy; OMS Mesencephalon |
41 |
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One-and-a-Half Syndrome Due to Pontine Hemorrhage | This is a 50-year-old woman who, while exercising in the gym, suddenly experienced vertigo, nausea, vomiting, tingling in the left arm, and diplopia. MRI demonstrated a brainstem hemorrhage that involved the right greater than left pons. Examination demonstrated a right horizontal gaze palsy due to ... | Abnormal Saccades; Sixth Nerve Palsy; INO; One-and-a-Half Syndrome; Jerk Nystagmus; Gaze Evoked Nystagmus |