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TitleDescriptionType
26 Periodic Alternating NystagmusA patient with PAN is shown with a discussion of its appearance and etiology.Image/MovingImage
27 Recording and Modeling Eye MovementsA brief discussion of the power and perhaps limitations of eye movement modeling is presented.Image/MovingImage
28 See-saw NystagmusTwo 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
29 Square Wave JerksThese 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
30 Up-beat Nystagmus with Palatal MyoclonusA woman who appears to have upbeat nystagmus is also noted to have palatal, labial, and sternocleidomastoid myoclonus.Image/MovingImage
31 Upbeat NystagmusA 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
32 Various Causes of OphthalmoplegiaAs 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
33 Vertical Gaze ParalysisA 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
34 Voluntary NystagmusIn 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
35 Wall-Eyed Internuclear OphthalmoplegiaSome 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
36 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
37 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
38 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
39 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
40 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
41 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
42 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
43 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
44 Nystagmus NomenclatureA brief discussion of the various types of nystagmus is provided.Image/MovingImage
45 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
46 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
47 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
48 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
49 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
50 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
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