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Title | Description | Type |
26 |
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One and Half Syndrome | This involves both gaze palsy secondary to a lesion of the ipsilateral PPRF or VI nucleus, and an INO secondary to a lesion of the MLF on the same side. If the VI nucleus is involved, VII palsy almost always occurs due to the proximity of the VII fascicle to the VI nucleus. | Image/MovingImage |
27 |
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Opsoclonus | The differential diagnosis in adults is presented, followed by probably the most dramatic example of this disorder ever filmed. The father of American Neuro-ophthalmology, Dr. Frank Walsh, gave a copy of the film to Dr. J. Lawton Smith who, in turn, gave a copy to me. | Image/MovingImage |
28 |
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Opsoclonus in an Infant | An infant with Infantile Opsoclonus-Myoclonus ("Dancing Eyes, Dancing Feet"), with a likely underlying neuroblastoma is shown and the differential diagnosis of opsoclonus in infants and children is listed. | Image/MovingImage |
29 |
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Parinaud's Syndrome or Dorsal Midbrain Syndrome | Also known as the pretectal, or sylvian aqueduct syndromes, it is characterized by paralysis of upgaze to both saccades and pursuit. In this video, the causes of Parinaud's, along with its signs of large pupils with light-near dissociation, spastic-paretic accommodation, pathologic lid retraction (... | Image/MovingImage |
30 |
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Pause Cell Dysfunction: Ocular Flutter | Burst neurons are tonically inhibited by the pause neurons, which lie in the nucleus raphe interpositus. Lesions of the pause neurons result in ocular flutter. | Image/MovingImage |
31 |
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Pause Cell Dysfunctions | This reviews the ocular oscillations caused by pause cell dysfunctions. | Image/MovingImage |
32 |
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Periodic Alternating Nystagmus | A patient with PAN is shown with a discussion of its appearance and etiology. | Image/MovingImage |
33 |
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Progressive Supranuclear Palsy | A 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 |
34 |
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Psychogenic Gaze Palsy | Psychogenic Gaze-Palsy is unusual but can usually be detected during Oculo-cephalics when the eyebrows don't elevate during attempted upward gaze. | Image/MovingImage |
35 |
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Recording and Modeling Eye Movements | A brief discussion of the power and perhaps limitations of eye movement modeling is presented. | Image/MovingImage |
36 |
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See-saw Nystagmus | Two patients with see-saw nystagmus are presented. The nystagmus is usually due to a suprasellar lesion associated with a bitemporal hemianopsia or a rostral midbrain lesion. The nystagmus is conjugate and torsional with a dissociated vertical vector so that the intorting eye rises and the extortin... | Image/MovingImage |
37 |
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Square Wave Jerks | These are the most common ocular oscillations, since they occur in normals, particularly in the elderly and in many neurological disorders. They fall under a category called "saccades intrusions." A man with very subtle square waves is presented, followed by a woman with larger amplitude square wav... | Image/MovingImage |
38 |
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Superior Oblique Myokymia | This 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 |
39 |
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Up-beat Nystagmus with Palatal Myoclonus | A woman who appears to have upbeat nystagmus is also noted to have palatal, labial, and sternocleidomastoid myoclonus. | Image/MovingImage |
40 |
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Upbeat Nystagmus | A female patient with upbeating nystagmus that increases in amplitude with upward gaze is shown. This type of nystagmus commonly occurs from a lesion involving one of three regions: the ponto-medullary junction, ponto-mesencephalic junction, and the anterior cerebellum. Etiologies of these lesions... | Image/MovingImage |
41 |
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Various Causes of Ophthalmoplegia | As a resident, I missed the diagnoses of Ocular-Myasthenia Wernicke's, and Thyroid Eye Disease. To remind myself to consider these etiologies, I developed the "3 T's: Tensilon, Thiamine, and Thyroid. As the years past, I added two more T's: Tropia and Trauma. | Image/MovingImage |
42 |
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Vertical Gaze Paralysis | A patient is shown with up, down, and leftward gaze palsies as a result of a presumed right-sided high midbrain lesion. (He was encountered prior to the introduction of CT scanning, so that localization could not be verified). He had normal vestibulo-ocular reflexes. In addition, he had a curious ... | Image/MovingImage |
43 |
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Voluntary Nystagmus | In this video, a woman shows her ability to voluntarily induce an ocular oscillation. It is called "voluntary nystagmus", although the oscillation consist of back-to-back saccades, such as occurs in ocular flutter. Clues to the voluntary nature of this oscillation are mentioned. At times, however, ... | Image/MovingImage |
44 |
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Wall-Eyed Internuclear Ophthalmoplegia | Some patients with bilateral INOs are exotropic. Convergence is variable; it may be completely normal in both eyes, absent bilaterally, or present in one eye only. | Image/MovingImage |
45 |
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Whipples Mimicking PSP | A 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 |
46 |
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Introduction to Eye Movements | This 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 |
47 |
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Cerebral Control of Eye Movements | In 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 |
48 |
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Anatomy and Physiology of the Saccade System | Saccades 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 |
49 |
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Saccadic System | The 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 |
50 |
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Pursuit System | The 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 |