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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Filters: Collection: ehsl_novel_gold
| Title | Description | Subject | ||
|---|---|---|---|---|
| 26 |
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Reversal of Vertical Nystagmus with Convergence in Anti-DPPX Encephalitis | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a man who initially presented with spontaneous upbeat and torsional nystagmus, which led to the diagnosis of anti-DPPX encephalitis (for further details on this patient's course and for a video of his nystagmus, s... | Upbeat Nystagmus; Downbeat Nystagmus; Jerk Nystagmus; Gaze-Evoked Nystagmus |
| 27 |
 |
Two Patients with Parinaud's Syndrome with Slow Upward Saccades and Normal Upward Range of Movements | Presented here are two patients with Parinaud's syndrome: Patient 1) suffered a hemorrhage of the dorsal midbrain causing slow upward saccades (with convergence retraction nystagmus, but normal vertical range of eye movements), and light-near dissociation, and Patient 2) had a germinoma of the dorsa... | Abnormal Saccades; Dorsal Midbrain; Jerk Nystagmus; Gaze Evoked Nystagmus |
| 28 |
 |
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 |
| 29 |
 |
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 |
| 30 |
 |
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 |
| 31 |
 |
Upbeat Nystagmus & Ocular Flutter Due to Cerebellar Pilocytic Astrocytoma | This is a 20-year-old woman who was diagnosed with a cerebellar pilocytic astrocytoma at age 10 after presenting with severe headaches and hydrocephalus. She underwent incomplete resection and radiation therapy at that time. She experienced mild vertical oscillopsia in upgaze at baseline, and increa... | Upbeat Nystagmus; Ocular Flutter |
| 32 |
 |
Sequelae of Cerebellar Hemorrhage - Gaze-evoked Nystagmus, Alternating Skew Deviation and Palatal Tremor | This is a 75-yo-woman presenting with a gait disorder. Two years prior, she suffered a cerebellar hemorrhage. On examination, there were typical cerebellar ocular motor signs including gaze-evoked nystagmus, choppy smooth pursuit and VOR suppression, and saccadic dysmetria. There was also an alterna... | Assessing Abnormal Alignment; Jerk Nystagmus; Gaze Evoked Nystagmus; Oculopalatal Myoclonus |
| 33 |
 |
Impaired Smooth Pursuit and Other Characteristic Ocular Motor Findings in Middle Cerebellar Peduncle Stroke | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 50-year-old woman who underwent resection of a left-sided acoustic neuroma, and post-operatively, she had vertigo, binocular diplopia, left hemi-ataxia and severe gait ataxia. MR diffusion weighted imaging demon... | Abnormal Pursuit; VOR-HIT Abnormal; Abnormal Alignment; Vestibulocochlear Nerve; OMS Pons; Jerk Nystagmus; Gaze-Evoked Nystagmus; Bruns Nystagmus; Vestibular Nystagmus; Acute Vestibular Syndrome |
| 34 |
 |
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 |
| 35 |
 |
Rebound Nystagmus | This is a 50-yo-man who presented for dizziness and imbalance. His exam demonstrated choppy smooth pursuit and VOR suppression as well as mild gait ataxia. There was mild right-beating nystagmus in right gaze and left-beating nystagmus in left gaze without vertical gaze-evoked nystagmus. Occasionall... | Cerebellar; Jerk Nystagmus; Gaze Evoked Nystagmus; Rebound Nystagmus |
| 36 |
 |
Unilateral 3rd, 4th, and 6th Nerve Palsies Due to Cavernous Sinus Meningioma | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 50-year-old woman presenting with a partial 3rd nerve palsy (mild pupil involvement), partial 6th nerve palsy, and no clear incyclotorsion with downgaze, suggestive of additional 4th nerve palsy, all on the left... | Abnormal Range; Third Nerve Palsy; Aberrant Regeneration; Fourth Nerve Palsy; Sixth Nerve Palsy; Jerk Nystagmus; Downbeat Nystagmus; Gaze Evoked Nystagmus; Abnormal Saccades |
| 37 |
 |
Gaze-evoked and Rebound Nystagmus in a Cerebellar Syndrome | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: 30-yo-man with the subacute onset of a cerebellar syndrome. After extensive evaluation and progression, it was thought that this represented an autoimmune process and there was some improvement with immunosuppression. He ... | Jerk Nystagmus; End-gaze Nystagmus; Gaze-evoked Nystagmus; Rebound Nystagmus; Cerebellar Pathology |
| 38 |
 |
Sagging Eye Syndrome and Cerebellar Disease in Divergence Insufficiency | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 70-year-old woman who presented with diplopia at distance. Her exam demonstrated orthophoria at near with a fairly comitant 8-10 PD esotropia at distance without abduction paresis, consistent with divergence ins... | Abnormal Alignment; OMS Cerebellar; Jerk Nystagmus; Gaze Evoked Nystagmus; Divergence Insufficiency |
| 39 |
 |
Alternating Hypertropias - Bilateral 4th Nerve Palsies and Alternating Skew Deviation | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: Seen here are two patients with alternating hypertropias. The first is a 70-year-old woman with a diagnosis of cerebellar ataxia, neuropathy, vestibular areflexia syndrome (CANVAS). In the video, both spontaneous downbeat... | Skew Deviation; Alignment; Fourth Nerve Palsy; Cerebellar Pathology; Jerk Nystagmus; Downbeat Nystagmus; Gaze Evoked Nystagmus |
| 40 |
 |
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 |
| 41 |
 |
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 |
| 42 |
|
Test Your Knowledge: The Acute Vestibular Syndrome with Gaze-Evoked Nystagmus and Bilaterally Abnormal Head Impulse Testing Due to Middle Cerebellar Peduncle and Flocculus Hemorrhage | This is a 70-year-old woman with a history of atrial fibrillation on warfarin presenting with acute prolonged vertigo and imbalance. In addition to the findings demonstrated in the first part of the video, what else should be seen to reassure the examiner that the etiology of her vertigo is benign? ... | Abnormal VOR; Jerk Nystagmus; Acute Vestibular Syndrome; Cerebellar OMS; Gaze Evoked Nystagmus |
| 43 |
|
Test Your Knowledge - Central and Peripheral Vestibular and Ocular Motor Signs Due to a Large Vestibular Schwannoma | Which of the following is least likely to be the correct localization or etiology given the findings seen in the video? 1) Acute right 8th cranial neuropathy 2) Right-sided vestibular schwannoma 3) Right vestibular nucleus infarction 4) Right anterior inferior cerebellar artery distribution stroke A... | Abnormal VOR; Jerk Nystagmus; Vestibular Nystagmus; Gaze Evoked Nystagmus; Bruns Nystagmus; Cerebellar OMS |
| 44 |
 |
Ocular Motor & Vestibular Features of the MLF Syndrome | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This 61-year-old woman with HTN and DM presented for evaluation of acute onset diagonal diplopia. Adduction OS was about 60% of normal while medialization OS improved with convergence. In right gaze, dissociated abducti... | INO; Jerk Nystagmus; Torsional Nystagmus; Gaze-evoked Nystagmus |
| 45 |
 |
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... | Jerk Nystagmus; Gaze-Evoked Nystagmus; Vestbular Nystagmus; Eighth Cranial Nerve; Vestibulocochlear Nerve; Cerebellar OMS |
| 46 |
|
Central Positional Vertigo and Nystagmus in a Posterior Fossa Tumor | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 30-year old woman who presented with positional vertigo and vomiting following a concussion related to a car accident 3 months prior. She was initially diagnosed with posterior canal (PC) benign paroxysmal posit... | Vestibular Nystagmus; Jerk Nystagmus; Gaze-Evoked Nystagmus; Central Positional Nystagmus; Cerebellar OMS; Downbeat Nystagmus; Upbeat Nystagmus |
| 47 |
 |
Pendular, Gaze-Evoked and Abducting Nystagmus in MS | This is a 40-year-old woman with a history of multiple sclerosis who presented for oscillopsia. On examination, she had bilateral internuclear ophthalmoplegia (INO-adduction lag OU and abducting nystagmus OU), with a corresponding exotropia that increased in right and left gaze. She also had horiz... | Jerk Nystagmus; INO; Pendular Nystagmus; Abducting Nystagmus; Gaze-Evoked Nystagmus; Cerebellar OMS |
| 48 |
 |
Peripheral (Vestibular) and Central (Gaze-Evoked) Patterns of Nystagmus in a Single Patient | A 55-year-old man experienced episodic vertigo and was diagnosed with Meniere's disease affecting the left ear (based on audiograms and his clinical course) about 1 year prior to presentation. About 6 months prior to presentation, intratympanic (IT) gentamicin was injected into the left ear, at whic... | Jerk Nystagmus; Vestibular Nystagmus; Bruns; Gaze Evoked Nystagmus; VOR HIT Abnormal |
| 49 |
 |
Bruns Nystagmus Due to a Cerebellopontine Angle Tumor | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 15-yo-girl who experienced headache and imbalance leading to an MRI which showed a left sided cerebellopontine angle (CPA) tumor. Because of involvement of the left brainstem/cerebellum (e.g., dysfunction of the... | Jerk Nystagmus; Gaze Evoked Nystagmus; Vestibular Nystagmus |
| 50 |
 |
Paraneoplastic Downbeat Nystagmus and Cerebellar Ataxia Due to Small Cell Lung Carcinoma | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 61-year-old woman (non-smoker) who developed a gait disorder, dizziness and oscillopsia that was progressive over 2 months. Exam demonstrated spontaneous downbeat nystagmus with side pocket nystagmus in lateral ... | Jerk Nystagmus; Downbeat Nystagmus; Cerebellar Ataxia; Carcinoma |