NOVEL - Daniel Gold Collection
 
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76 The Geotropic Variant of Horizontal Canal BPPV𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 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
77 Multiple Cranial Neuropathies Due to Glomus TumorThis is a woman who was diagnosed with a right sided glomus tumor, and subsequently underwent resection. Seen here are multiple cranial neuropathies related to the tumor itself as well as to the surgery. She cannot abduct the right eye due to a right CN VI palsy. She has a right lower motor neuron f...Image/MovingImage
78 Multiple Lower Cranial Neuropathies Following Carotid EndarterectomyThis is a patient who underwent a right carotid endarterectomy (CEA). Following the surgery, multiple right sided lower cranial nerves were involved. In his case, there was trapezius and sternocleidomastoid weakness and atrophy on the right, indicative of right CN XI injury. There was an absent gag ...Image/MovingImage
79 Neuro-Ophthalmic Features and Pseudo-MG Lid Signs in Miller Fisher Syndrome𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 51-year-old woman who presented with imbalance, acute onset dizziness and diplopia that developed over three days following two weeks of upper respiratory infection and bacterial conjunctivitis. When she was ini...Image/MovingImage
80 Neuro-Ophthalmic Features and Pseudo-MG Lid Signs in Miller Fisher Syndrome (Figure 1)This is a 51-year-old woman who presented with imbalance, acute onset dizziness and diplopia that developed over three days following two weeks of upper respiratory infection and bacterial conjunctivitis. When she was initially seen as an outpatient, nystagmus was noted to the right and left, and a ...Image
81 Ocular Motor Signs in Early Progressive Supranuclear Palsy𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 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...Image/MovingImage
82 Oculopalatal Tremor with Prominent Nystagmus, Bilateral Horizontal Gaze Palsy, and Bilateral Facial Palsies𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 50-year-old woman who experienced the acute onset of right sixth and seventh nerve palsies and left hemiparesis. Two cavernomas within the right pons (one in the region of the facial colliculus) were demonstrat...Image/MovingImage
83 Oculopalatal Tremor with Prominent Nystagmus, Bilateral Horizontal Gaze Palsy, and Bilateral Facial Palsies (Figure 1)Figure 1, MRI T2 sequence demonstrating hyperintensities involving bilateral inferior olives of the medulla. This is a 50-year-old woman who experienced the acute onset of right sixth and seventh nerve palsies and left hemiparesis. Two cavernomas within the right pons (one in the region of the facia...Image
84 Periodic Alternating Nystagmus Due to Nodulus StrokeThis 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...Image/MovingImage
85 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...Image
86 Posterior Canal BPPV Pre- and Post-Epley Maneuver𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a patient with typical right posterior canal benign paroxysmal positional vertigo (BPPV), which was provoked by the Dix-Hallpike maneuver. When the patient was moved into the right Dix-Hallpike maneuver, after a b...Image/MovingImage
87 Posterior Canal BPPV Treated with Semont ManeuverThis is a patient with left posterior canal (PC) benign paroxysmal positional vertigo (BPPV), and upbeat-torsional (towards the left ear) nystagmus was provoked by left Dix-Hallpike maneuver and left side-lying maneuver. This video demonstrates treatment of her left PC BPPV with the Semont maneuver....Image/MovingImage
88 Relationship Between Semicircular Canals and Extraocular MusclesFigure 1: When stimulated, each of the 6 angular acceleration detecting semicircular canals (3 on the right and 3 on the left) responds with a conjugate eye movement, with the vector(s) indicated below. PC=posterior canal; HC=horizontal (also known as lateral) canal; AC=anterior (also known as super...Image
89 Skew Deviation and Spontaneous Nystagmus Due to Posterior Fossa LesionsThis is a 50-year-old woman who reported the abrupt onset of imbalance, right upper extremity incoordination and binocular vertical diplopia several months prior to her presentation to our clinic. On examination, she had a left hypertropia that was fairly comitant (measuring 5 prism diopters) assoc...Image/MovingImage
90 Slow Volitional Saccades and Poor Fast Phases to an Optokinetic Stimulus, with Preserved Head Impulse TestingThis 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...Image/MovingImage
91 Subtle Torsional Pendular Nystagmus in Oculopalatal Tremor (OPT)𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 50-year-old woman who presented with imbalance, and MRI demonstrated a right cerebellar cavernous malformation. She underwent surgery to resect the malformation, and post-operatively experienced right hemiparesi...Image/MovingImage
92 Subtle Torsional Pendular Nystagmus in Oculopalatal Tremor (OPT) (Figure 1)This is a 50-year-old woman who presented with imbalance, and MRI demonstrated a right cerebellar cavernous malformation. She underwent surgery to resect the malformation, and post-operatively experienced right hemiparesis and ataxia. Six months after the surgery, balance worsened and vision became ...Image
93 Trigeminal Motor Neuropathy with Weakness and Atrophy of the Muscles of MasticationThis is a man who was diagnosed with polio in childhood, which involved the motor (VIII) division of the right trigeminal nerve. The motor portion of the trigeminal nerve innervates the muscles of mastication (temporalis, masseter - both of which demonstrate wasting in this patient - as well as the ...Image/MovingImage
94 Trigeminal Neuropathy with Loss of the Corneal ReflexThis is a woman who underwent radiofrequency ablation for left trigeminal neuralgia. Examination demonstrated loss of facial sensation on the left in addition to an absent corneal reflex on the left, consistent with involvement of the V1 (ophthalmic) branch of the trigeminal nerve. When the cornea i...Image/MovingImage
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