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 | Type | ||
|---|---|---|---|---|
| 26 |
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Dissociated Elliptical Pendular Nystagmus in MS | This is a patient with multiple sclerosis who presented with oscillopsia. Seen in the video is an elliptical pendular nystagmus in both eyes that was dissociated. Here, the term "dissociated" refers to the fact that the nystagmus is (slightly) more intense in the left eye as compared to the right ... | Image/MovingImage |
| 27 |
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Vestibular Neuritis with + Head Impulse Test and Unidirectional Nystagmus (Figure 1) | Vestibular neuritis is the most common cause of the acute vestibular syndrome, which is characterized by continuous vertigo and spontaneous nystagmus lasting days. It may be mimicked by central causes, including stroke, but in the hands of subspecialists, the HINTS+ (Head Impulse, Nystagmus, Test of... | Image |
| 28 |
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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 |
| 29 |
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Downbeat Nystagmus and Convergence Spasm | This is a 60-yo-woman with vertical oscillopsia related to her downbeat nystagmus, and diplopia related to an intermittent esotropia. When the esotropia was present, with versions there were bilateral abduction deficits. With ductions and the vestibulo-ocular reflex, it was apparent that the range o... | Image/MovingImage |
| 30 |
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Idiopathic Downbeat Nystagmus, Decreasing with Convergence | This is a 25-yo-woman who experienced vertically oscillopsia for 1 year, and was found to have downbeat nystagmus. Interestingly, there were no other cerebellar ocular motor signs - e.g., normal saccades, smooth pursuit, VOR suppression, and no gaze-evoked nystagmus, although her (pure) downbeat was... | Image/MovingImage |
| 31 |
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Cerebellar Degeneration with Downbeat Nystagmus Provoked by Convergence | Description: This is a 70-yo-woman with a progressive gait disorder, diagnosed with cerebellar ataxia. She displayed typical cerebellar ocular motor signs including gaze-evoked nystagmus, choppy pursuit and VOR suppression, and there was very subtle spontaneous downbeat nystagmus, best appreciated w... | Image/MovingImage |
| 32 |
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The Influence of Convergence on Downbeat Nystagmus | This is a patient presenting with progressive imbalance and oscillopsia over the course of approximately 1 year. On examination, he had cerebellar ataxia in addition to spontaneous downbeat nystagmus (DBN). His downbeat nystagmus increased in lateral and downgaze, which are characteristic features,... | Image/MovingImage |
| 33 |
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Idiopathic Downbeat Nystagmus Exacerbated with Positional Maneuvers - Part 2: Patient is Now on 4-Aminopyridine | This is a 45-yo-woman presented in "Idiopathic downbeat nystagmus exacerbated with positional maneuvers". This video was taken after the patient had been on 4-aminopyridine for 3 months. There was marked improvement in subjective oscillopsia and objective downbeat nystagmus. The strong positional co... | Image/MovingImage |
| 34 |
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Traumatic 3rd Nerve Palsy with Aberrant Regeneration | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 20-yo-woman who experienced severe head trauma and diplopia upon awakening from a coma several weeks after the injury. She had a partial left 3rd nerve palsy (adduction spared), and when she looked to the right ... | Image/MovingImage |
| 35 |
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Aberrant Regeneration of the 3rd Nerve | Aberrant regeneration in two patients: 1) a young woman with a right cavernous sinus meningioma with subsequent development of aberrant regeneration demonstrated by eyelid elevation OD in attempted downgaze (i.e., some fibers that were supposed to innervate the right IR were misrouted to the right l... | Image/MovingImage |
| 36 |
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Physiologic End Point Nystagmus | This is a normal subject with end point nystagmus in lateral gaze. Features that favor physiologic (normal) end point nystagmus (EPN) rather than pathologic gaze-evoked nystagmus include: only present in far lateral gaze (at close to 100% of the normal range of ocular movements); resolves when the v... | Image/MovingImage |
| 37 |
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Monocular Horizontal Pendular Nystagmus in MS | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: Both of these patients have MS and monocular (OS) horizontal pendular nystagmus. The first patient seen in the video has normal afferent function and no evidence of optic nerve disease in either eye, while the second pati... | Image/MovingImage |
| 38 |
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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... | Image/MovingImage |
| 39 |
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A Comparison of Nystagmus and Saccadic Intrusions/Oscillations | Nystagmus can be classified into pendular and jerk waveforms, where both are generated by a slow, pathologic phase. Corrective phase (the position reset mechanism) differs. In pendular nystagmus, the eyes move back and forth with about the same velocity and amplitude, similar to that of a pendulum... | Image |
| 40 |
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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 |
| 41 |
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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 |
| 42 |
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Pendular Nystagmus and Vision Loss | Three patients are presented here, each with poor vision (counting fingers or worse) related to retinitis pigmentosa in one patient (Usher's syndrome) and optic neuropathy in two patients, each of whom developed pendular nystagmus after vision loss developed. Visually mediated movements normally pre... | Image/MovingImage |
| 43 |
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Idiopathic Downbeat Nystagmus Exacerbated with Positional Maneuvers | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 45-yo-woman with vertical oscillopsia for 6+ months, found to have downbeat nystagmus on examination. She mainly complained of dizziness and oscillopsia when laying down. She was found to have a significant exac... | Image/MovingImage |
| 44 |
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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.... | Image/MovingImage |
| 45 |
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Positional Downbeat Nystagmus Mimicking Anterior Canal BPPV | Although positional downbeat nystagmus (pDBN) can indicate the rare anterior canal variant of benign paroxysmal positional vertigo, central mimics are common causes of pDBN. pDBN may be seen in multiple system atrophy (MSA), or seen with posterior fossa lesions, with a common example being a stroke ... | Image/MovingImage |
| 46 |
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Monocular Downbeat Nystagmus Due to a Posterior Fossa Cyst | This is a 40-yo-man who experienced months of imbalance and was found to have an epidermoid cyst (immediately posterior to the 4th ventricle), which was resected. Months after surgery, he experienced monocular vertical oscillopsia. On examination, there was subtle downbeat nystagmus (DBN) in the rig... | Image/MovingImage |
| 47 |
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Chiari Malformation Causing Downbeat Nystagmus in Lateral Gaze | This is a 20-yo-man who presented with oscillopsia in lateral gaze from downbeat nystagmus (DBN). In primary gaze, very subtle DBN was only noted with ophthalmoscopy, but in lateral gaze, prominent DBN was present. Other central ocular motor signs included gaze-evoked nystagmus (GEN) vertically, in ... | Image/MovingImage |
| 48 |
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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... | Image/MovingImage |
| 49 |
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Spontaneous Upbeat Nystagmus in Acute Wernicke's Encephalopathy | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 40-year-old woman presenting with imbalance, confusion and oscillopsia. Exam demonstrated upbeat nystagmus (UBN) in primary gaze that remained UB in all directions of gaze, with a slight torsional component (top... | Image/MovingImage |
| 50 |
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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... | Image/MovingImage |