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Title | Description | Subject |
126 |
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The Most Common Vestibular Conditions Categorized by Timing and Triggers, with Specific Historical Features that Should be Sought for Each (Adapted from Approach to the Ocular Motor and Vestibular History and Examination) | Adapted from https://collections.lib.utah.edu/ark:/87278/s64x9bq1 | Summary and Review |
127 |
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The Most Common Vestibular Conditions Categorized by Timing and Triggers, with Specific Ocular Motor and Vestibular Features that Should be Sought for Each | HINTS+ = Head Impulse, Nystagmus, Test of Skew, ‘Plus' bedside assessment of auditory function; HIT = head impulse test; NP = nerve palsy; BPPV = benign paroxysmal positional vertigo; SCDS = superior canal dehiscence syndrome; BVL = bilateral vestibular loss; PPPD = persistent postural perceptual ... | Vestibular Examination |
128 |
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Nystagmus Due to Paraneoplastic (Anti-Yo) Brainstem and Cerebellar Degeneration | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 40-yo-woman with anti-Yo antibody associated with ovarian cancer. Initial symptoms 2.5 years prior (to this video) included imbalance and dysarthria. She complained of oscillopsia which was due to her upbeat nys... | Abnormal Saccades; Abnormal VORS; Cerebellar; Jerk Nystagmus; Upbeat Nystagmus; Gaze Evoked Nystagmus |
129 |
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Ocular Motor Signs in Brainstem Demyelinating Disease - Spontaneous Upbeat, Vertical Gaze-Evoked Nystagmus, Slow Saccades, Bilateral Vestibular Loss, INOs | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 25-year-old woman who presented with painful vision loss bilaterally two years prior to this video recording, which was diagnosed as optic neuritis. Months later, she experienced oscillopsia and binocular horizo... | Abnormal Saccades; Abnormal VOR-HIT; Abnormal Range; INO; Upbeat Nystagmus; Abducting Nystagmus; Gaze-Evoked Nystagmus |
130 |
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Ocular Motor Signs in Progressive Supranuclear Palsy (PSP) | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 65-yo-woman complaining of imbalance and double vision. She had significant convergence insufficiency (and would close her right eye with near viewing), providing an explanation for her diplopia. Convergence ins... | Abnormal Pursuit; Abnormal Range; Upgaze Palsy; Downgaze Palsy; Mesencephalon; Square Wave Jerks |
131 |
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Ocular Motor Signs in SCA 6 | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 45-yo-man who was recently diagnosed with SCA 6. There was no clear spontaneous downbeat nystagmus (DBN) in primary gaze, although DBN could clearly be provoked by convergence. Other ocular motor features includ... | Abnormal Convergence; Abnormal VORS; OMS Cerebellar; Downbeat Nystagmus; Jerk Nystagmus; Gaze Evoked Nystagmus; Rebound Nystagmus |
132 |
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Ocular Motor Signs of Cerebellar Ataxia - Gaze-Evoked Nystagmus, Saccadic Pursuit, and VOR Supression | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 30-year-old woman with a several year long history of imbalance due to cerebellar ataxia of unclear etiology. Seen in this video are common ocular motor signs in patients with advanced cerebellar dysfunction inc... | Jerk Nystagus; Gaze-Evoked Nystagmus; Abnormal Pursuit; Abnormal VORS; Rebound Nystagmus |
133 |
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One-and-a-Half Syndrome, Facial Palsy, and Nystagmus Due to Dorsal Pontine Demyelination | This is a 16-yo-girl with oscillopsia and double vision. Exam showed inability to look to the left with either eye due to left nuclear 6th. There was also a left INO (horizontal gaze palsy + INO = one-and-a-half syndrome) from left MLF involvement and left lower motor neuron facial palsy due to fasc... | One-and-a-half Syndrome; Horizontal Gaze Palsy; Pons; Jerk Nystagmus; Upbeat Nystagmus; Facial Nerve Palsy; Internuclear Ophthalmoplegia |
134 |
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Opsoclonus Provoked by Convergence | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 40-yo-man with post-infectious opsoclonus-myoclonus syndrome. Opsoclonus was intermittently evident in primary position, but was consistently provoked (and intensified) by convergence. Occasionally, opsoclonus (... | Abnormal Convergence; Opsoclonus |
135 |
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Organic Convergence Spasm and Nystagmus in Posterior Fossa Lymphoma | This is a 20-year-old woman, who 9 months prior to this video, first experienced episodes of vertigo and vomiting occurring when lying down or rolling over in bed. Gastrointestinal work-up was unrevealing and MRI was performed which demonstrated "multifocal nodular enhancing lesions along the ependy... | Spasm |
136 |
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Oscillopsia and Bilateral Vestibular Loss with Gentamicin Ototoxicity | Patients with bilateral vestibular loss commonly experience oscillopsia with head movements, or an inability to stabilize retinal images with subsequent bouncing or jumping of the environment due to loss of vestibular function. This causes significant blurring of vision and disorientation, dizziness... | Abnormal VOR; Abnormal HIT |
137 |
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Oscillopsia: A Common Symptom of Bilateral Vestibular Loss | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This video is an example of what a patient with bilateral vestibular loss experiences while walking. Without a VOR, there is no mechanism to ensure retinal stability of the world with each head movement, and oscillopsia (... | VOR Abnormal; HIT Abnormal |
138 |
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Palato-ocular Synchrony in Oculopalatal Tremor | This is a patient with OPT due to a pontine hemorrhage, and although she did have torsional pendular nystagmus, it was very subtle. However, with eyelid closure, much larger vertical ocular oscillations could be seen, which were in fact synchronous with her palatal tremor. This finding, sometimes ... | |
139 |
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Paraflocculus (Tonsillar) Ocular Motor Syndrome and Dysmetria in a Chiari Malformation - Pre and Post-Operative Exams | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 25-year-old woman presenting with 6 months or progressive imbalance, binocular vertical diplopia, and occipital headaches, which were brought on or aggravated by coughing or sneezing. Examination demonstrated hy... | Saccades; Skew Diviation; VOR Supression; Pursuit; Medulla |
140 |
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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 |
141 |
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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 |
142 |
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Paroxysmal Ocular Tilt Reaction | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 60-year-old woman who 2 years prior experienced a left sided hypertensive hemorrhagic stroke, resulting in right hemiparesis, dysarthria and vertical diplopia. The initial vertical diplopia resolved completely a... | Midbrain OMS; Skew Deviation; Jerk Nystagmus; Abnormal Alignment |
143 |
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Pendular Nystagmus | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is an example of pendular nystagmus, where like jerk nystagmus, the slow phase initiates the movement. However, unlike jerk nystagmus, there is no fast phase, but rather back to back slow phases resembling a pendulum... | |
144 |
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Pendular Nystagmus and Ocular Motor Signs in MS | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 30-year-old man with a 15 year history of multiple sclerosis. For the last 12 months, he experienced horizontal oscillopsia. On examination, there were ocular motor abnormalities including gaze-evoked nystagmus,... | Pendular Nystagmus; Jerk Nystagmus; Gaze Evoked Nystagmus; Abnormal Saccades |
145 |
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Pendular Nystagmus and Vision Loss | Three patients are presented here, each with poor vision (counting fingers or worse) related to retinitis pigmentosa in one patient (Usher's syndrome) and optic neuropathy in two patients, each of whom developed pendular nystagmus after vision loss developed. Visually mediated movements normally pre... | Pendular Nystagmus |
146 |
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Periodic Alternating Nystagmus and Central Head-Shaking Nystagmus from Nodulus Injury | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 35-year-old man who suffered a gunshot wound to his cerebellum. When he regained consciousness days later, he experienced oscillopsia due to periodic alternating nystagmus (PAN). He was started on baclofen 10 mg... | Jerk Nystagmus; Gaze-Evoked Nystagmus; Abnormal Headshake; Periodic Alternating Nystagmus |
147 |
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Periodic Alternating Nystagmus and Perverted Head-shaking Nystagmus in Cerebellar Degeneration | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 60-yo-woman with several years of worsening imbalance, diplopia (hers was actually unrelated to cerebellar pathology [although she did have an esotropia greater at distance that was cerebellar in origin] and due... | Headshaking; Cerebellar; Jerk Nystagmus; Periodic Alternating Nystagmus |
148 |
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Periodic Alternating Nystagmus Due to a Chiari Malformation | This patient first experienced oscillopsia 12 months prior to this video. Three months after the onset of symptoms, she was seen by neuro-ophthalmology and found to have a spontaneous, unidirectional left-beating nystagmus (that did not reverse) in addition to saccadic smooth pursuit. Oscillopsia wo... | |
149 |
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Periodic Alternating Nystagmus Due to Nodulus Stroke | This is a 70-year-old woman who experienced the acute onset of vertigo and imbalance. MRI demonstrated a diffusion-weighted imaging hyperintensity involving the nodulus (with corresponding ADC hypointensity) consistent with an acute stroke. On examination several weeks after the stroke, periodic alt... | Periodic Alternating Nystagmus; Jerk Nystagmus |
150 |
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Periodic Alternating Nystagmus Due to Nodulus Stroke (Figure 1) | This is a 70-year-old woman who experienced the acute onset of vertigo and imbalance. MRI demonstrated a diffusion-weighted imaging hyperintensity involving the nodulus (with corresponding ADC hypointensity) consistent with an acute stroke. On examination several weeks after the stroke, periodic alt... | Periodic Alternating Nystagmus; Jerk Nystagmus |