NOVEL - Robert B. Daroff Collection
 
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IdentifierTitleDescriptionSubject
26 Daroff_03-10Ocular DysmetriaUpon attempted refixation, patients with this cerebellar eye sign over-shoot and oscillate, before eventually reaching their intended targets. Two patients demonstrate this disorder.Cerebellar Dysmetria; Ocular Dysmetria; Other Saccadic Abnormalities
27 Daroff_03-11Anatomy 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...Saccades; Saccadic Eye Movements; Supranuclear Input
28 Daroff_03-12Anatomy and Physiology of NystagmusThe role of the cerebellum in modifying the output of the neural integrator is discussed. Impaired integration causes jerk nystagmus with increasing or decreasing velocity exponential slow phases.Nystagmus
29 Daroff_03-13Pause Cell Dysfunction: Ocular FlutterBurst neurons are tonically inhibited by the pause neurons, which lie in the nucleus raphe interpositus. Lesions of the pause neurons result in ocular flutter.Ocular Flutter
30 Daroff_03-14Ocular FlutterOcular Flutter, a disorder characterized by intermittent, rapid, horizontal movements in primary position, is demonstrated in this video.Ocular Flutter
31 Daroff_03-2Periodic Alternating NystagmusA patient with PAN is shown with a discussion of its appearance and etiology.Periodic Alternating Nystagmus
32 Daroff_03-3Nystagmus NomenclatureA brief discussion of the various types of nystagmus is provided.Nystagmus
33 Daroff_03-4Downbeat NystagmusPrimary position downbeat nystagmus is demonstrated, with a list of the common causes.Downbeat Nystagmus
34 Daroff_03-5Chiari Malformation: Eye MovementsThe eye movement disorders commonly accompanying Chiari malformations are listed. These are generally the same as with lesions of the cerebellum.Arnold-Chiari Malformation; Eye Movement Disorders; Chiari Malformation
35 Daroff_03-6Upbeat 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...Upbeat Nystagmus
36 Daroff_03-7Alexander's LawThis describes the observed increase in vestibular nystagmus with gaze in the direction of the fast phase, and its decrease with gaze in the slow phase direction.Alexander's Law; Vestibular Ocular System; Vestibular Nystagmus
37 Daroff_03-8Up-beat Nystagmus with Palatal MyoclonusA woman who appears to have upbeat nystagmus is also noted to have palatal, labial, and sternocleidomastoid myoclonus.Up-beat Nystagmus; Palatal Myoclonus
38 Daroff_03-9Ocular Palatal MyoclonusThe 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...Ocular Palatal Myoclonus; Oculopalatal Myoclonus; Oculopalatal Tremor
39 Daroff_04-1Opsoclonus in an InfantAn 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.Opsoclonus
40 Daroff_04-10Eyelid 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...Eyelid Nystagmus
41 Daroff_04-11Recording and Modeling Eye MovementsA brief discussion of the power and perhaps limitations of eye movement modeling is presented.Eye Movement Disorders; Eye Movement Measurements
42 Daroff_04-12Eye Movement Modeling; Eye-Ear TricksA surgical resident was able to combine eye and ear movements as a party trick, to intimidate a first year neurology resident.Eye Movement Modeling; Eye-Ear Tricks
43 Daroff_04-2OpsoclonusThe 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.Opsoclonus; Saccadomania
44 Daroff_04-3Square 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...Square Wave Jerks
45 Daroff_04-4Macro Square Wave JerksA 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."Macro Square Wave Jerks
46 Daroff_04-5Voluntary 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, ...Voluntary Nystagmus; Voluntary Flutter
47 Daroff_04-6Pause Cell DysfunctionsThis reviews the ocular oscillations caused by pause cell dysfunctions.Pause Cell Dysfunctions
48 Daroff_04-7See-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...See-saw Nystagmus; Seesaw Nystagmus
49 Daroff_04-8Superior Oblique MyokymiaThis 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...Superior Oblique Myokymia; Trochlear Nerve Disease
50 Daroff_04-9Ocular BobbingThis is characterized by an initial fast phase downward, followed by a slow phase up, which is the reverse of nystagmus, where a corrective fast phase follows the slow phase. Most patients with bobbing have a large pontine lesion and are comatose with paralyzed horizontal eye movements. The patien...Ocular Bobbing; Ocular Motility Disorders
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