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Title | Description | Type |
26 |
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Saccades | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: The examiner should note: conjugacy (a lag of the adducting eye may be seen with an INO); accuracy (posterior fossa lesions commonly produce dysmetria (overshooting or undershooting); velocity (if slow, may suggest a lesi... | Image/MovingImage |
27 |
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Saccadic Dysmetria and Ocular Lateropulsion in Lateral Medullary Stroke | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 30-yo-man who suffered a right lateral medullary stroke. Examination showed saccadic hypermetria to the right (ipsilesional), hypometria to the left (contralesional)and rightward ocular lateropulsion (ipsilesion... | Image/MovingImage |
28 |
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Saccadic Hypermetria and Ipsipulsion (Behind Closed Eyelids and with Vertical Saccades) | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 40-year-old woman who experienced oscillopsia and vertical diplopia, due to spontaneous torsional nystagmus and a skew deviation (right hypotropia), respectively. The symptom onset was 7 months prior to these vi... | Image/MovingImage |
29 |
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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 |
30 |
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Saccadic Pathways in the Brainstem and Cerebellum & Mechanism for Saccadic Dysmetria in Wallenberg Syndrome - Normal Function of the Brainstem/Cerebellar Saccadic Pathways | The inferior cerebellar peduncle (ICP) carries climbing fibers to the dorsal vermis, and these fibers have an inhibitory influence over the Purkinje cells. These Purkinje cells normally inhibit the ipsilateral fastigial nucleus, and the fastigial nucleus projects to the contralateral inhibitory burs... | Image |
31 |
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Slow Abducting Saccade in 6th Nerve Palsy | 40-yo-man with a right fascicular 6th nerve palsy due to stroke. There was improvement and only a minimal residual right abduction paresis OD by this visit, but still a relatively slow right abducting saccade seen in the video, especially apparent in the slow motion segment. Video shows slow abduct... | Image/MovingImage |
32 |
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Slow Horizontal, Vertical, Oblique Saccades and Gaze-evoked Nystagmus in Anti-AGNA-1 Encephalitis | This is a patient who presented subacutely with imbalance and dizziness. On examination, she had evidence of gaze evoked nystagmus, right internuclear ophthalmoplegia, as well as slow saccades horizontally and vertically. She was diagnosed with a rare antibody-mediated disorder, anti-AGNA-1 (antig... | Image/MovingImage |
33 |
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Slow Saccades Due to Unilateral Paramedian Pontine Reticular Formation (PPRF) Injury with Preserved Movements Using the Vestibulo-Ocular Reflex | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 60-year-old man who presented for imbalance and oscillopsia 10 months after surgery and 8 months after radiation for Merkel cell carcinoma of the neck. He developed imbalance after surgery and diplopia and osci... | Image/MovingImage |
34 |
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Slow Volitional Saccades and Poor Fast Phases to an Optokinetic Stimulus, with Preserved Head Impulse Testing | This is a 67-year-old woman presenting with imbalance and binocular horizontal diplopia at near. On examination there were frequent square wave jerks, limited supraduction OU and convergence insufficiency, which explained her diplopia. Pursuit and suppression of the vestibulo-ocular reflex were sa... | Image/MovingImage |
35 |
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Square Wave Jerks and Macrosaccadic Oscillations in a Patient with a Cerebellar Tumor | This is a 40-year-old man who developed severe headaches, confusion, and gait imbalance which led to neuroimaging which demonstrated a midline cerebellar mass with compression of the fourth ventricle and obstructive hydrocephalus. He underwent a suboccipital craniectomy for resection of the mass, an... | Image/MovingImage |
36 |
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Test Your Knowledge - Oscillopsia | This 65-year-old man with multiple sclerosis described that objects in front of him appear to spontaneously jump or move horizontally for the last few months. He reported that his symptoms occur independent of head movements and head impulse testing was normal. After viewing the video, what is the m... | Image/MovingImage |
37 |
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Test Your Knowledge - Vertical Saccadic Palsy Due to Bilateral riMLF Infarctions | This is a 30-year-old who was found minimally responsive on the lounge floor of an ice skating rink. He was brought to the ED, where he had a GCS score of 8 (where 15 is normal) for poor responsiveness. His ocular motor exam is shown in the video. Regarding Finding #1, which of the following is fals... | Image/MovingImage |
38 |
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Test Your Knowledge - Vertical-Torsional Nystagmus | Question #1: Watch the first portion of the video until you are told to stop. Is this vestibular nystagmus more likely to be peripheral or central? A. Peripheral B. Central Answer for #1: A. Incorrect. While the patient has upbeat-torsional (top poles beating toward the right ear) nystagmus which is... | Image/MovingImage |
39 |
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The Acute Vestibular Syndrome with Dysarthria, Dysphagia, Dysphonia, Hemi-ataxia, and Saccadic Dysmetria Due to the Lateral Medullary (Wallenberg) Syndrome | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 50-year-old woman with the acute onset of vertigo, dysarthria, dysphagia and dysphonia/hoarseness (nucleus ambiguus), ptosis and imbalance. Her examination localized to a left lateral medullary (Wallenberg) synd... | Image/MovingImage |
40 |
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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... | Image/MovingImage |
41 |
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Unidirectional Nystagmus in Lateral Medullary Syndrome | This is a 70-yo-man who presented with acute vertigo. Examination demonstrated very mild spontaneous torsional nystagmus (towards the right ear) in primary (not seen well in this video), with robust downbeat-torsional (towards right ear) nystagmus in right gaze and (less robust) almost pure torsiona... | Image/MovingImage |
42 |
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Wall-eyed Bilateral INO in Caudal Midbrain Lesion | This is a 30-yo-woman with the relatively acute onset of diplopia. There was a large angle exotropia, very subtle lag of the adducting saccades OD>OS, suggestive of bilateral INOs. This was best seen with rapid horizontal saccades, and a lesion involving bilateral MLFs in the caudal midbrain was dem... | Image/MovingImage |
43 |
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riMLF Syndrome from Artery of Percheron Stroke | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 65-yo-man who suffered the abrupt onset of loss of consciousness followed by difficulty looking down. MRI showed bilateral rostral midbrain strokes in the distribution of the artery of Percheron. He could not in... | Image/MovingImage |