NOVEL - Robert B. Daroff Collection
 
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1 Whipples Mimicking PSPA patient is shown with nuchal dystonic ridigity, profound retropulsion, limited range of horizontal saccades, an almost complete vertical gaze palsy, normal vestibulo-ocular eye movements, and apraxia of eyelid opening. His pendular convergence nystagmus was the clue that he had CNS Whipple's Dise...Image/MovingImage
2 Progressive Supranuclear PalsyA patient with PSP demonstrates bilateral hypometric saccades, bilateral low-gain pursuit, vertical gaze palsy, and normal vestibulo- ocular reflexes. A second PSP patient is unable to make saccades or pursue horizontally. With optokinetic stimulation, the eyes move somewhat. Cold caloric stimula...Image/MovingImage
3 Introduction to Eye MovementsThis brief clip reveals how eye movements subserve vision, and provides an overview of each of the four eye movement systems: saccadic, smooth pursuit, vergence, and vestibular.Image/MovingImage
4 Cerebral Control of Eye MovementsIn this series, the purpose and nomenclature of eye movements are described, with the anatomical pathways generating and controlling the cortically-driven movements -- saccades and smooth pursuit in horizontal gaze, upgaze and downgaze -- discussed in detail. The importance of each of the three sac...Image/MovingImage
5 Anatomy and Physiology of the Saccade SystemSaccades depend on a pulse-step firing pattern that allows an initiation of the saccade (pulse), and maintenance of the new eye position in space (step). This video explains the anatomical pathway for this type of activation. The burst cells, which lie in the PPRF, generate the pulse, while the nu...Image/MovingImage
6 Saccadic SystemThe anatomical pathways of saccades are described. These primarily involve the frontal eye fields (FEF), mesencephalic reticular nuclei, pontine paramedian reticular formation (PPRF), and cranial nerve nuclei III, IV, and VI. The three saccadic generators in the cortex are in the contralateral FEF...Image/MovingImage
7 Pursuit SystemThe anatomical pathways of smooth pursuit are described, stressing the importance of the cerebellum that, in contrast to the saccadic system, relays information between the cortex and brain stem. The outcomes of specific cortical lesions are discussed and the important concept of gain is introduced.Image/MovingImage
8 Cerebellar Eye Signs: OverviewThe wide array of cerebellar eye signs, includes, among others, saccadic intrusions and oscillations, nystagmus, gaze palsies, and impairment of the vestibulo-ocular reflex.Image/MovingImage
9 Gustatory Lid Retraction in Congenital Horner's SyndromeA young girl with unilateral ptosis from a congenital Horner's syndrome demonstrates a distinctively rare phenomenon of resolution of the ptosis by sucking lemon juice.Image/MovingImage
10 Miscellaneous Ocular OscillationsIn this final series, several eye movement abnormalities are detailed with patients used to illustrate each. KEY WORDS: opsoclonus-myoclonus, opsoclonus, square wave jerks, macro square wave jerks, pause cell dysfunction, voluntary nystagmus, eyelid nystagmus, see-saw nystagmus, superior oblique my...Image/MovingImage
11 Nystagmus NomenclatureA brief discussion of the various types of nystagmus is provided.Image/MovingImage
12 Accomodative Gaze Palsy or Convergence SpasmThis is a psychogenic disorder that may mimic lateral rectus palsy. The clue is pupillary constriction during attempted lateral gaze.Image/MovingImage
13 Psychogenic Gaze PalsyPsychogenic Gaze-Palsy is unusual but can usually be detected during Oculo-cephalics when the eyebrows don't elevate during attempted upward gaze.Image/MovingImage
14 Cerebellar Eye SignsLesions of the cerebellum can result in a variety of eye movement disorders, including saccadic intrusions and oscillations, such as ocular dysmetria, as well as nystagmus, gaze palsies, and dysfunction of the vestibular ocular reflex. In this series of videos, these disorders are discussed in rela...Image/MovingImage
15 Eyelid NystagmusLid nystagmus is of three types. The most common is associated with vertical ocular nystagmus with the lid movement being synchronous with the eyes, but with greater aplitutde. The second type is associated with gaze evoked horizontal nystagmus and may occur in the lateral medullary syndrome. A p...Image/MovingImage
16 Chiari Malformation: Eye MovementsThe eye movement disorders commonly accompanying Chiari malformations are listed. These are generally the same as with lesions of the cerebellum.Image/MovingImage
17 Superior Oblique MyokymiaThis eye movement abnormality presents with intermittent monocular oscillopsia, often following a particular eye movement or head tilt. The examiner will often miss the abnormality unless it can be provoked. It represents a microtremor of a superior oblique muscle and usually responds to an anticon...Image/MovingImage
18 Ocular BobbingThis is characterized by an initial fast phase downward, followed by a slow phase up, which is the reverse of nystagmus, where a corrective fast phase follows the slow phase. Most patients with bobbing have a large pontine lesion and are comatose with paralyzed horizontal eye movements. The patien...Image/MovingImage
19 Alexander's LawThis describes the observed increase in vestibular nystagmus with gaze in the direction of the fast phase, and its decrease with gaze in the slow phase direction.Image/MovingImage
20 Anatomy and Physiology of NystagmusThe role of the cerebellum in modifying the output of the neural integrator is discussed. Impaired integration causes jerk nystagmus with increasing or decreasing velocity exponential slow phases.Image/MovingImage
21 Bilateral Horizontal Gaze PalsyA patient with a bilateral PPRF lesion displays intact vertical gaze and convergence.Image/MovingImage
22 Bilateral Internulcear OphthalmoplegiaA woman with a bilateral INO demonstrates impaired adduction and nystagmus of the abducting eyes. Her vertical gaze is intact. The dissociated optokinetic nystagmus, due to an inability of the medial recti to generate normal saccades, is again shown.Image/MovingImage
23 Brain Stem Eye Movement SyndromesIn this series, the importance of the brainstem in eye movements is discussed, with particular emphasis is placed on the signficance of the paramedian pontine reticular formation (PPRF), the medial longitudinal fasciculus (MLF), and the nuclei and projections of cranial nerves III and VI. Correlat...Image/MovingImage
24 Classifications of Internuclear OphthalmoplegiaBoth the Lutz and Cogan classifications of INO separate them into anterior and posterior varieties. The Cogan classification, which depends upon the presence or absence of convergence, is not particularly useful for localization. The Lutz posterior INO, which is a supranuclear pareses of abduction, ...Image/MovingImage
25 Defective PursuitA patient with a cerebral hemispherectomy manifests ipsilateral low-gain (saccadic) pursuit, and impaired optokinetic nystagmus when the targets are moved towards the lesioned side. The multiple causes of pursuit abnormalities are discussed.Image/MovingImage
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