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Title | Description | Type |
26 |
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Defective Saccades: Frontal Lobe Lesion | A patient with a right frontal lobe infarction demonstrates loss of saccades to the left with preservation of pursuit. | Image/MovingImage |
27 |
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Defective Saccades: Slow to No Saccades | In this video, the many causes of this syndrome are listed, and a patient demonstrates the consequence of being unable to generate saccadic eye movements. On cold caloric stimulation, his eyes deviate tonically to the side of the stimulation without fast phases to the opposite side. | Image/MovingImage |
28 |
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Downbeat Nystagmus | Primary position downbeat nystagmus is demonstrated, with a list of the common causes. | Image/MovingImage |
29 |
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Eye Movement Modeling; Eye-Ear Tricks | A surgical resident was able to combine eye and ear movements as a party trick, to intimidate a first year neurology resident. | Image/MovingImage |
30 |
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Gaze Evoked Ear Retraction | Large ears normally retract during ipsilateral gaze, as shown in this segment. However, it won't be noted unless you look for it. "You see what you look for, and you look for what you know." | Image/MovingImage |
31 |
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Horizontal Eye Movements | The anatomic pathway involved in horizontal saccadic eye movements include the frontal eye fields, paramedian pontine reticular formation (PPRF), medial longitudinal fasciculus (MLF), and cranial nerve nuclei III and VI. The pathway for the vestibulo- ocular reflex (VOR) passes through the PPRF at ... | Image/MovingImage |
32 |
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Internuclear Ophthalmoplegia | Lesions of the MLF cause an INO, which manifests as ipsilateral palsies of adduction, and nystagmus of the contralateral abducted eye. Vertical gaze is preserved. Inducing optokinetic nystagmus so that the adducting eye is responsible for the fast phase, causes a dissociation between the two eyes, a... | Image/MovingImage |
33 |
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Macro Square Wave Jerks | A woman with multiple sclerosis has a postural tremor and macro square wave jerks. These indicate a cerebellar outflow problem. Macro square wave jerks are somewhat of a misnomer since the eye movements are not entirely square; an alternate descriptor is "square wave pulses." | Image/MovingImage |
34 |
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Normal Vertical Eye Movements | The brain stem pathway for vertical saccades involves the PPRF, rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF), nucleus of Cajal, and the nuclei of cranial nerves III and IV. For upgaze, projections from the riMLF traverse through the posterior commissure, whereas there ... | Image/MovingImage |
35 |
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Ocular Dysmetria | Upon attempted refixation, patients with this cerebellar eye sign over-shoot and oscillate, before eventually reaching their intended targets. Two patients demonstrate this disorder. | Image/MovingImage |
36 |
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Ocular Flutter | Ocular Flutter, a disorder characterized by intermittent, rapid, horizontal movements in primary position, is demonstrated in this video. | Image/MovingImage |
37 |
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Ocular Myasthenia Gravis | A man with limited ocular excursions and only small amplitude saccades, improves with Tensilon, this illustrates the need to always consider ocular myasthenia in the differential diagnosis in patients with limited eye movements. Rapid restricted saccades, as this patient demonstrates, are diagnosti... | Image/MovingImage |
38 |
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Ocular Palatal Myoclonus | The relevant anatomy of this disorder involves the inferior olivary nucleus, projecting via the restiform body to the contralateral dentate nucleus, traveling to the contralateral red nucleus via the superior cerebellar peduncle, and finally back to the inferior olivary nucleus via the central tegme... | Image/MovingImage |
39 |
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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 |
40 |
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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 |
41 |
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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 |
42 |
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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 |
43 |
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Pause Cell Dysfunctions | This reviews the ocular oscillations caused by pause cell dysfunctions. | Image/MovingImage |
44 |
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Periodic Alternating Nystagmus | A patient with PAN is shown with a discussion of its appearance and etiology. | Image/MovingImage |
45 |
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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 |
46 |
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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 |
47 |
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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 |
48 |
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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 |
49 |
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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 |
50 |
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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 |