A collection of videos relating to the diagnosis and treatment of eye movement disorders. This collection includes many demonstrations of examination techniques.
Dan Gold, D.O., Associate Professor of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine.
A collection of videos relating to the diagnosis and treatment of eye movement disorders.
NOVEL: https://novel.utah.edu/
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A 'Canal Jam' During Head Impulse Testing in a Patient With Horizontal Canal BPPV | A 70-year-old man reported brief episodes of positional vertigo. Ten years prior, he had undergone gamma knife radiosurgery for a vestibular schwannoma at the left cerebellopontine angle. Video head impulse testing (vHIT) showed reduced gains and corrective saccades in the planes of the left horizon... | 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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Active Head Impulse Test | Active head impulse test (HIT): instruct the patient to fix their eyes on the camera and turn their head 20o to the right/left, and then make a rapid movement toward the midline to align their head with the camera again, keeping their eyes fixed on the camera throughout. A simple instruction is to a... | Image/MovingImage |
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The Affected-Ear-up 90 degree Maneuver (HC-Canalithiasis) | The Affected-Ear-up 90 degree Maneuver is used to treat horizontal canal-canalithaisis. 1. The patient starts in a supine position. 2. The patient rotates their head 90 degrees towards the unaffected side. 3. The patient sits up. | Text |
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The Affected-Ear-up 90 degree Maneuver (HC-Canalithiasis) (Video) | The Affected-Ear-up 90 degree Maneuver is used to treat horizontal canal-canalithaisis. 1. The patient starts in a supine position. 2. The patient rotates their head 90 degrees towards the unaffected side. 3. The patient sits up. | 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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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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Apogeotropic and Downbeat Central Positional Nystagmus Provoked While Seated | This is a young man with intermittent complaints of positional vertigo. With Dix-Hallpike and roll testing, he had apogeotropic positional nystagmus (e.g., right beating nystagmus with the left ear down, and left beating nystagmus with the right ear down) in addition to strong downbeat nystagmus in... | Image/MovingImage |
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Assessing Utricle Pathway Function and the Effects of Convergence on Nystagmus in Acute Vestibular Neuritis | A 35-year-old woman presented a few days after the onset of room-spinning vertigo. She denied diplopia, dysarthria, dysphagia, dysphonia, incoordination, numbness, and weakness. On examination, she had subtle spontaneous right-beat nystagmus (RBN). This nystagmus increased in amplitude and frequency... | Image/MovingImage |
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Audiometry: What Does It Look Like and How Do I Interpret It? | An audiogram measures a patient's auditory threshold responses with pure-tone stimuli across a range of sound frequencies that are important for human communication, typically 250 Hz to 8000 Hz. The threshold is the sound intensity level at which an individual detects the tone 50% of the time. Heari... | Text |
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Basics of Acute Stroke Treatment | A brief overview of management of acute stroke treatment. | Text |
| 12 |
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BBQ Roll for Right Horizontal Canal BPPV, Canalithiasis (Geotropic Nystagmus) | The BBQ Roll/Lampert Maneuver has been shown to be an effective treatment and is supported by a level I classification study. 1. The patient starts in a supine position with the head positioned 30 degrees above the horizon. 2. While maintaining head elevation, the patient's head (or whole body) is r... | Text |
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BBQ Roll for Right Horizontal Canal BPPV, Canalithiasis (Geotropic Nystagmus) (Video) | The BBQ Roll/Lampert Maneuver has been shown to be an effective treatment and is supported by a level I classification study. 1. The patient starts in a supine position with the head positioned 30 degrees above the horizon. 2. While maintaining head elevation, the patient's head (or whole body) is r... | Image/MovingImage |
| 14 |
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Bow and Lean Test | The Bow and Lean Test is used to identify the affected side and is designed to be used in conjunction with or after the Supine Roll Test. Within this test a null point may exist where the nystagmus will extinguish because the cupula is in a gravity neutral position. As this test involves the patient... | Text |
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Bow and Lean Test (Video) | The Bow and Lean Test is used to identify the affected side and is designed to be used in conjunction with or after the Supine Roll Test. Within this test a null point may exist where the nystagmus will extinguish because the cupula is in a gravity neutral position. As this test involves the patient... | Image/MovingImage |
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Brandt-Daroff Exercises | Brandt-Daroff exercises are less effective than the Epley and the Semont maneuvers and are not shown to prevent recurrence [1-3]. Brandt-Daroff exercises may still be beneficial for habituation exercises and to reduce phobic responses to lying supine or side-lying after the resolution of BPPV. This ... | Text |
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Brandt-Daroff Exercises (Video) | Brandt-Daroff exercises are less effective than the Epley and the Semont maneuvers and are not shown to prevent recurrence [1-3]. Brandt-Daroff exercises may still be beneficial for habituation exercises and to reduce phobic responses to lying supine or side-lying after the resolution of BPPV. This ... | 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 |
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The Canalith Repositioning Maneuver/Epley Maneuver for Right Posterior Canal Benign Paroxysmal Positional Vertigo | Posterior canal (PC) accounts for 70-90% cases of BPPV [1-3] and resolves with canalith repositioning maneuvers 90% of the time [4-20]. The Epley maneuver is considered a gold-standard treatment, with class 1 evidence for use. | Text |
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The Canalith Repositioning Maneuver/Epley Maneuver for Right Posterior Canal Benign Paroxysmal Positional Vertigo (Video) | Posterior canal (PC) accounts for 70-90% cases of BPPV [1-3] and resolves with canalith repositioning maneuvers 90% of the time [4-20]. The Epley maneuver is considered a gold-standard treatment, with class 1 evidence for use. | Image/MovingImage |
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Central Vestibular Nystagmus in Anti-DPPX Encephalitis | This is a young woman who presented with oscillopsia due to spontaneous nystagmus in addition to gastrointestinal symptoms which led to the diagnosis of anti-DPP axis encephalitis. She was treated with rituximab, and experience gradual improvement over time. However, years after the onset, she con... | Image/MovingImage |
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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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Change in Pendular Nystagmus from Oculopalatal Tremor over a Four-year Period | This is a patient who developed oculopalatal tremor months following a pontine hemorrhage. Although it is not shown here, she also has palatal tremor. In the first video which was taken 1 year after her hemorrhage, a vertical-torsional pendular nystagmus can be seen, that is mildly dissociated giv... | Image/MovingImage |
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Convergence | Convergence: instruct the patient to focus on their thumb held at arm's length, and slowly move their thumb towards their nose. This may bring out or cause reversal of vertical nystagmus (e.g., transition from upbeat to downbeat nystagmus in Wernicke's encephalopathy [see example of transition from ... | Image/MovingImage |
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Curved Oblique Saccades and Saccadic Slowing in a Patient with an Anti-GAD Mediated Posterior Fossa Syndrome | This is a patient who developed muscle spasms especially involving the muscles of the trunk in addition to a progressive gait disorder. Examination demonstrated slow saccades, slower horizontally than vertically, in addition to gaze evoked nystagmus with a side pocket pattern. Side pocket nystagmu... | Image/MovingImage |