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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Figure 53: Vascular Distribution and Anatomy Relevant to the Lateral Medullary (Wallenberg) Syndrome (Supplement) | Image | |
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Figure 53: Vascular Distribution and Anatomy Relevant to the Lateral Medullary (Wallenberg) Syndrome (Supplement) | Image | |
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Figure 64: The Course of the 3rd (III) Nerve | The 3rd nucleus lies at the ventral border of the periaqueductal gray matter, at the level of the superior colliculus. In between the two nuclei is the midline central caudal nucleus (CCN), which innervates bilateral levator palpebrae muscles (explaining how a unilateral nuclear 3rd can cause bilate... | Image |
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Figure 64: The Course of the 3rd (III) Nerve (Supplement) | Image | |
| 30 |
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Figure 65: Vascular Distribution and Anatomy (Including 3rd Nerve) of the Rostral Midbrain | In this axial section of the midbrain at the level of the superior colliculus, the paired 3rd nuclei are located ventral to the periaqueductal grey, and the midline central caudal nucleus (CCN) is located in between. The fascicles that exit the IIIrd nuclei carry the fibers destined to innervate the... | Image |
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Figure 65: Vascular Distribution and Anatomy (Including 3rd Nerve) of the Rostral Midbrain (Supplement) | Image | |
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Figure 65: Vascular Distribution and Anatomy (Including 3rd Nerve) of the Rostral Midbrain (Supplement) | Image | |
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Figure 68: The Course of the 4th (IV) Nerve | The 4th nucleus lies at the ventral border of the periaqueductal gray matter, at the level of the inferior colliculus. The fascicles exit the nucleus dorsally and decussate at the anterior medullary velum (anterior floor of the fourth ventricle), and then exit the brainstem dorsally. The peripheral ... | Image |
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Figure 68: The Course of the 4th (IV) Nerve (Supplement) | Image | |
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Figure 69: Vascular Distribution and Anatomy (Including 4th Nerve) of the Caudal Midbrain | In this axial section of the midbrain at the level of the inferior colliculus, the 4th nuclei are located ventral to the periaqueductal grey, dorsal to the medial longitudinal fasciculus (MLF) and medial to the oculosympathetic tract. Fascicles exit the nucleus dorsally and decussate at the anterior... | Image |
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Figure 69: Vascular Distribution and Anatomy (Including 4th Nerve) of the Caudal Midbrain (Supplement) | Image | |
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Figure 69: Vascular Distribution and Anatomy (Including 4th Nerve) of the Caudal Midbrain (Supplement) | Image | |
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Figure 80: Vascular Distribution and Anatomy Relevant to the Medial Medullary Syndrome | This axial section of the medulla highlights those structures that, when damaged, are often responsible for spontaneous upbeat nystagmus (UBN). The nucleus of Roller and nucleus intercalatus normally have an inhibitory influence over the cerebellar flocculus, and when there is a lesion of Roller/int... | Image |
| 39 |
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Figure 80: Vascular Distribution and Anatomy Relevant to the Medial Medullary Syndrome (Supplement) | Image | |
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Figure 80: Vascular Distribution and Anatomy Relevant to the Medial Medullary Syndrome (Supplement) | Image | |
| 41 |
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Medullary Structures Relevant to the Ocular Motor and Vestibular Consequences of Lateral Medullary (Wallenberg) Syndrome | This is an axial section of the medulla showing the structures that, when damaged, are responsible for the vestibular and ocular motor features of the lateral medullary or Wallenberg syndrome. The nucleus prepositus hypoglossi (NPH) and medial vestibular nucleus (MVN) complex is important for horizo... | Image |
| 42 |
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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 |
| 43 |
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Saccadic Pathways in the Brainstem and Cerebellum & Mechanism for Saccadic Dysmetria in Wallenberg Syndrome - Abnormal Function of the Brainstem/Cerebellar Saccadic Pathways with a Left Wallenberg Syndrome | The end result of a lesion involving the climbing fibers within the left lateral medulla is deficient rightward saccades (contralesional hypometric saccades), and over-active leftward saccades (ipsilesional hypermetric saccades), and ipsilesional ocular lateropulsion given this baseline imbalance. M... | Image |
| 44 |
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Sagittal Section of the Midbrain Showing Structures Related to Normal Eyelid Function | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: During a vertical saccade, the rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF) is activated, which excites the superior rectus (SR) and inferior oblique (IO) (IIIrd nerve) subnuclei. Additionall... | Image |
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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 |
| 46 |
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Triangle of Guillain-Mollaret | Seen here is a schematic representation of the Gullain-Mollaret triangle (Figure 1), also referred to as the dentato-olivary pathway, reflecting the 3 points of this imaginary triangle - 1) dentate nucleus, 2) red nucleus, and 3) inferior olivary nucleus. The olive sends decussating climbing fibers ... | Image |
| 47 |
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Using Video Head Impulse Testing to Unmask Covert Saccades in Compensated Vestibular Neuritis (Figures 1 and 2) | This is a 30-year-old woman who experienced the acute vestibular syndrome (prolonged vertigo for >24 hours, nausea, unsteadiness, spontaneous nystagmus, head motion intolerance) and was diagnosed with vestibular neuritis. This diagnosis was based on a positive head impulse test to the left (see Figu... | Image |
| 48 |
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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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Brainstem Ocular Motor Machinery | Seen here is a sagittal view of the brainstem. The medulla has a significant role in gaze-holding, and the nucleus prepositus hypoglossi (NPH, along with the medial vestibular nucleus ) is the horizontal neural integrator. The abducens (6th) nucleus is located in the dorsal pons, and sends off the 6... | Image/MovingImage |
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Medullary Structures Relevant to Upbeat Nystagmus | This is an axial section of the medulla, slightly more caudal as compared to (please refer to figure "medullary structures relevant to the ocular motor and vestibular consequences of the lateral medullary (Wallenberg) syndrome). Again seen are the inferior cerebellar peduncle (ICP) and caudal aspect... | Image |