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Title | Description | Type |
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CANVAS (Cerebellar Ataxia, Neuropathy, and Vestibular Areflexia Syndrome) Video Head Impulse Test (vHIT) Figure | CANVAS (Cerebellar Ataxia, Neuropathy, and Vestibular Areflexia Syndrome) is a genetic condition consisting of slowly progressive late-onset ataxia, bilateral vestibulopathy, sensory neuropathy, chronic cough, and autonomic dysfunction. While the term vestibular areflexia typically implies bilateral... | Image |
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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 | Text |
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Elliptical Pendular Nystagmus in MS | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 40-yo-woman with MS and bilateral optic nerve disease who presented with a year's long history of oscillopsia, which was related to elliptical pendular nystagmus. The appearance of elliptical nystagmus is the re... | Image/MovingImage |
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Eye Signs in Infantile Esotropia - Latent Nystagmus and Inferior Oblique Overaction | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 25-yo-man with a history of amblyopia and intermittent eye crossing. On exam, he had a comitant 25 prism diopter esotropia, and other features of infantile (or congenital) esotropia including: latent nystagmus (... | Image/MovingImage |
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Internuclear Ophthalmoplegia (INO) in Multiple Sclerosis | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This video includes 3 patients each with a known history of MS found to have unilateral or bilateral INOs on their exam. In the first 2 patients, the INOs are relatively subtle with normal adduction. However, with rapid h... | Image/MovingImage |
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Typical Features of Duane Syndrome Type 1 | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a patient seen for vestibular complaints, who on exam, was found to have (unrelated to her vestibular symptoms) impaired abduction OS. In adduction, there was narrowing of the palpebral fissure OS, a result of glo... | Image/MovingImage |
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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... | Image/MovingImage |
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An Approach to the Patient with (Recent Onset) Spontaneous Episodic Vestibular Syndrome | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: A vascular etiology should always be on the differential diagnosis of the recent onset of the spontaneous (unprovoked) episodic vestibular syndrome (EVS), especially in the older population and when vascular risk factors ... | Image |
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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,... | Image/MovingImage |
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An Approach to the Patient with Acute Onset Prolonged Vertigo | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: A vascular etiology should always be on the differential diagnosis of the acute onset prolonged vertigo, especially in the older population and when vascular risk factors are present. However, young patients can suffer fr... | Image |
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Centripetal Nystagmus Example | 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 |
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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 |
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A flowchart approach to nystagmus/intrusions | In tandem with the flowchart, the following added clues should be used to help with etiology: i) vector [horizontal, vertical, torsional]; ii) binocular or monocular; iii) spontaneous or provoked [e.g., BPPV]; iv) change with monocular viewing or gaze direction; v) rest of history, neurologic, and o... | Image/StillImage |
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Apraclonidine Testing in Horner's syndrome | This patient experienced relatively abrupt ptosis and was seen and diagnosed with a Horner's syndrome within a few days of the onset. There were no other exam findings and history did not offer clues as to the etiology. Neuroimaging of the oculosympathetic tract was unrevealing. Apraclonidine testin... | Image/MovingImage |
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Downbeat Nystagmus and Cerebellar Atrophy | This is a 40-year-old man with 2 years of progressive ataxia and oscillopsia. On examination, he had downbeat nystagmus (DBN), an ocular motor finding that is usually (but not always) associated with flocculus/paraflocculus dysfunction, which causes overaction of the anterior canal (upward or anti-g... | Image/MovingImage |
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Positional Nystagmus During an Attack of Vestibular Migraine | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: A 50-year-old woman presented to clinic after experiencing multiple episodes of hours-long vertigo attacks that were associated with headache, photophobia and phonophobia. She had a history of motion sickness and migraine... | Image/MovingImage |
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Test Your Knowledge - Bilateral 4th Nerve Palsies | Watch the video until instructed to stop. Which of the following features is likely to be present given her exam findings? A. Gaze-evoked nystagmus and impaired smooth pursuit B. History of traumatic brain injury C. History of blepharoplasty or brow lift surgery and prominence of superior sulcus on ... | Image/MovingImage |
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Upbeat Transitioning to Downbeat Nystagmus in Wernicke's Encephalopathy | This is a 30-year-old man with a history of alcohol abuse who presented to the hospital with inability to walk after several weeks of heavy drinking and malnutrition. While in the hospital, he noted that when he would look straight ahead, everything he saw would appear to be bouncing up and down - a... | Image/MovingImage |
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Wall-eyed Bilateral Internuclear Ophthalmoplegia (WEBINO) in MS | This is a young woman with a years-long history of multiple sclerosis who presented 2 years prior to this examination with complaints of oscillopsia (which was due to spontaneous upbeat nystagmus), as well as diplopia (which was due to bilateral internuclear ophthalmoplegia, INO). ; ; At the time of... | Image/MovingImage |
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Acute Vestibular Syndrome With Skew Deviation and Positive Head Impulse Test Due to a Demyelinating Lesion | This is a patient who initially presented with the acute vestibular syndrome (AVS, e.g., acute prolonged vertigo, spontaneous nystagmus). ; See https://collections.lib.utah.edu/details?id=187730 for additional history. ; Her HINTS (Head Impulse, Nystagmus, Test of Skew) testing indicated a central e... | Image/MovingImage |
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Bilateral Vestibular Loss With Gaze-Evoked Nystagmus and Saccadic Visually Enhanced VOR | This is 55-year-old man with the subacute onset of head movement-induced oscillopsia and dizziness. He had a history of psoriatic arthritis. He had not used medications known to be vestibulo-toxic such as gentamicin. ; Salient findings on his examination included 1) bilateral vestibular loss (BVL) d... | Image/MovingImage |
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Downbeat Nystagmus | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 40-year-old man with 2 years of progressive ataxia and oscillopsia. On examination, he had downbeat nystagmus (DBN), an ocular motor finding that is usually (but not always) associated with flocculus/parafloccul... | Image/MovingImage |
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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 |
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Torsional Jerk Nystagmus | Presented here are 3 patients with torsional jerk nystagmus. The first patient presented with vertigo and experienced oscillopsia due to her torsional nystagmus. Pure or predominantly torsional nystagmus is highly suggestive of a central process. Her nystagmus was unidirectional and followed Alexand... | Image/MovingImage |
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Bruns Nystagmus (During Video-Oculography) Due to Vestibular Schwannoma | A 25-year-old man with a history of right-sided hearing loss, headaches and imbalance was found to have a right vestibular schwannoma on MRI, and underwent a partial resection and radiotherapy. He denied symptoms of head movement dependent oscillopsia (i.e., suggestive of significant unilateral or b... | Image/MovingImage |