A collection of videos relating to the diagnosis and treatment of eye movement disorders. This collection includes many demonstrations of examination techniques.
Dan Gold, D.O., Associate Professor of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine.
A collection of videos relating to the diagnosis and treatment of eye movement disorders.
NOVEL: https://novel.utah.edu/
TO
Filters: Collection: ehsl_novel_gold
| Title | Description | Subject | ||
|---|---|---|---|---|
| 26 |
 |
Neuro-Ophthalmic Features and Pseudo-MG Lid Signs in Miller Fisher Syndrome (Figure 1) | This is a 51-year-old woman who presented with imbalance, acute onset dizziness and diplopia that developed over three days following two weeks of upper respiratory infection and bacterial conjunctivitis. When she was initially seen as an outpatient, nystagmus was noted to the right and left, and a ... | Abnormal VOR; Miller Fisher Syndrome; Myasthenia Gravis; Acute Vestibular Syndrome; Jerk Nystagmus; Gaze Evoked Nystagmus |
| 27 |
 |
Nystagmus Due to Paraneoplastic (Anti-Yo) Brainstem and Cerebellar Degeneration | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 40-yo-woman with anti-Yo antibody associated with ovarian cancer. Initial symptoms 2.5 years prior (to this video) included imbalance and dysarthria. She complained of oscillopsia which was due to her upbeat nys... | Abnormal Saccades; Abnormal VORS; Cerebellar; Jerk Nystagmus; Upbeat Nystagmus; Gaze Evoked Nystagmus |
| 28 |
 |
Ocular Motor & Vestibular Features of the MLF Syndrome | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This 61-year-old woman with HTN and DM presented for evaluation of acute onset diagonal diplopia. Adduction OS was about 60% of normal while medialization OS improved with convergence. In right gaze, dissociated abducti... | INO; Jerk Nystagmus; Torsional Nystagmus; Gaze-evoked Nystagmus |
| 29 |
 |
Ocular Motor & Vestibular Features of the MLF Syndrome (Figures 1, 2, and 3) | This 61-year-old woman with HTN and DM presented for evaluation of acute onset diagonal diplopia. Adduction OS was about 60% of normal while medialization OS improved with convergence. In right gaze, dissociated abducting nystagmus was present OD, and there was a clear adduction lag when asking he... | INO; Jerk Nystagmus; Torsional Nystagmus; Gaze-Evoked Nystagmus |
| 30 |
 |
Ocular Motor Signs in Brainstem Demyelinating Disease - Spontaneous Upbeat, Vertical Gaze-Evoked Nystagmus, Slow Saccades, Bilateral Vestibular Loss, INOs | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 25-year-old woman who presented with painful vision loss bilaterally two years prior to this video recording, which was diagnosed as optic neuritis. Months later, she experienced oscillopsia and binocular horizo... | Abnormal Saccades; Abnormal VOR-HIT; Abnormal Range; INO; Upbeat Nystagmus; Abducting Nystagmus; Gaze-Evoked Nystagmus |
| 31 |
 |
Ocular Motor Signs in SCA 6 | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 45-yo-man who was recently diagnosed with SCA 6. There was no clear spontaneous downbeat nystagmus (DBN) in primary gaze, although DBN could clearly be provoked by convergence. Other ocular motor features includ... | Abnormal Convergence; Abnormal VORS; OMS Cerebellar; Downbeat Nystagmus; Jerk Nystagmus; Gaze Evoked Nystagmus; Rebound Nystagmus |
| 32 |
|
Ocular Motor Signs of Cerebellar Ataxia - Gaze-Evoked Nystagmus, Saccadic Pursuit, and VOR Supression | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 30-year-old woman with a several year long history of imbalance due to cerebellar ataxia of unclear etiology. Seen in this video are common ocular motor signs in patients with advanced cerebellar dysfunction inc... | Jerk Nystagus; Gaze-Evoked Nystagmus; Abnormal Pursuit; Abnormal VORS; Rebound Nystagmus |
| 33 |
 |
One-and-a-Half Syndrome Due to Pontine Hemorrhage | This is a 50-year-old woman who, while exercising in the gym, suddenly experienced vertigo, nausea, vomiting, tingling in the left arm, and diplopia. MRI demonstrated a brainstem hemorrhage that involved the right greater than left pons. Examination demonstrated a right horizontal gaze palsy due to ... | Abnormal Saccades; Sixth Nerve Palsy; INO; One-and-a-Half Syndrome; Jerk Nystagmus; Gaze Evoked Nystagmus |
| 34 |
 |
Paraflocculus (Tonsillar) Ocular Motor Syndrome and Dysmetria in a Chiari Malformation - Pre and Post-Operative Exams | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 25-year-old woman presenting with 6 months or progressive imbalance, binocular vertical diplopia, and occipital headaches, which were brought on or aggravated by coughing or sneezing. Examination demonstrated hy... | Saccades; Skew Diviation; VOR Supression; Pursuit; Medulla |
| 35 |
 |
Paraneoplastic Downbeat Nystagmus and Cerebellar Ataxia Due to Small Cell Lung Carcinoma | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 61-year-old woman (non-smoker) who developed a gait disorder, dizziness and oscillopsia that was progressive over 2 months. Exam demonstrated spontaneous downbeat nystagmus with side pocket nystagmus in lateral ... | Jerk Nystagmus; Downbeat Nystagmus; Cerebellar Ataxia; Carcinoma |
| 36 |
 |
Pendular Nystagmus and Ocular Motor Signs in MS | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 30-year-old man with a 15 year history of multiple sclerosis. For the last 12 months, he experienced horizontal oscillopsia. On examination, there were ocular motor abnormalities including gaze-evoked nystagmus,... | Pendular Nystagmus; Jerk Nystagmus; Gaze Evoked Nystagmus; Abnormal Saccades |
| 37 |
 |
Pendular, Gaze-Evoked and Abducting Nystagmus in MS | This is a 40-year-old woman with a history of multiple sclerosis who presented for oscillopsia. On examination, she had bilateral internuclear ophthalmoplegia (INO-adduction lag OU and abducting nystagmus OU), with a corresponding exotropia that increased in right and left gaze. She also had horiz... | Jerk Nystagmus; INO; Pendular Nystagmus; Abducting Nystagmus; Gaze-Evoked Nystagmus; Cerebellar OMS |
| 38 |
 |
Periodic Alternating Nystagmus Due to Spinocerebellar Ataxia Type 6 | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This 50-yo-man complained of imbalance for several years and more recently oscillopsia. On examination, there was saccadic pursuit and VOR suppression in addition to gaze-evoked nystagmus with rebound, raising suspicion f... | Cerebellar; Jerk Nystagmus; Periodic Alternating Nystagmus; Gaze Evoked Nystagmus; Rebound Nystagmus |
| 39 |
|
Periodic Alternating Nystagmus and Central Head-Shaking Nystagmus from Nodulus Injury | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 35-year-old man who suffered a gunshot wound to his cerebellum. When he regained consciousness days later, he experienced oscillopsia due to periodic alternating nystagmus (PAN). He was started on baclofen 10 mg... | Jerk Nystagmus; Gaze-Evoked Nystagmus; Abnormal Headshake; Periodic Alternating Nystagmus |
| 40 |
 |
Peripheral (Vestibular) and Central (Gaze-Evoked) Patterns of Nystagmus in a Single Patient | A 55-year-old man experienced episodic vertigo and was diagnosed with Meniere's disease affecting the left ear (based on audiograms and his clinical course) about 1 year prior to presentation. About 6 months prior to presentation, intratympanic (IT) gentamicin was injected into the left ear, at whic... | Jerk Nystagmus; Vestibular Nystagmus; Bruns; Gaze Evoked Nystagmus; VOR HIT Abnormal |
| 41 |
 |
Rebound Nystagmus | This is a 50-yo-man who presented for dizziness and imbalance. His exam demonstrated choppy smooth pursuit and VOR suppression as well as mild gait ataxia. There was mild right-beating nystagmus in right gaze and left-beating nystagmus in left gaze without vertical gaze-evoked nystagmus. Occasionall... | Cerebellar; Jerk Nystagmus; Gaze Evoked Nystagmus; Rebound Nystagmus |
| 42 |
 |
Reversal of Vertical Nystagmus with Convergence in Anti-DPPX Encephalitis | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a man who initially presented with spontaneous upbeat and torsional nystagmus, which led to the diagnosis of anti-DPPX encephalitis (for further details on this patient's course and for a video of his nystagmus, s... | Upbeat Nystagmus; Downbeat Nystagmus; Jerk Nystagmus; Gaze-Evoked Nystagmus |
| 43 |
 |
Sagging Eye Syndrome and Cerebellar Disease in Divergence Insufficiency | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 70-year-old woman who presented with diplopia at distance. Her exam demonstrated orthophoria at near with a fairly comitant 8-10 PD esotropia at distance without abduction paresis, consistent with divergence ins... | Abnormal Alignment; OMS Cerebellar; Jerk Nystagmus; Gaze Evoked Nystagmus; Divergence Insufficiency |
| 44 |
 |
Sequelae of Cerebellar Hemorrhage - Gaze-evoked Nystagmus, Alternating Skew Deviation and Palatal Tremor | This is a 75-yo-woman presenting with a gait disorder. Two years prior, she suffered a cerebellar hemorrhage. On examination, there were typical cerebellar ocular motor signs including gaze-evoked nystagmus, choppy smooth pursuit and VOR suppression, and saccadic dysmetria. There was also an alterna... | Assessing Abnormal Alignment; Jerk Nystagmus; Gaze Evoked Nystagmus; Oculopalatal Myoclonus |
| 45 |
 |
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... | |
| 46 |
|
Spinocerebellar Ataxia Type 3 with Gaze-Evoked Nystagmus and Bilateral Vestibular Loss | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 50-year-old woman with an established diagnosis of spinocerebellar ataxia type 3 (SCA 3) with severe imbalance and head movement-induced oscillopsia. On examination, she had 1) bilateral vestibular loss (BVL) de... | Jerk Nystagmus; Gaze-Evoked Nystagmus; Abnormal VOR-HIT; Eighth Nerve; Abnormal Pursuit |
| 47 |
 |
Test Your Knowledge - Central and Peripheral Vestibular and Ocular Motor Signs Due to a Large Vestibular Schwannoma | Which of the following is least likely to be the correct localization or etiology given the findings seen in the video? 1) Acute right 8th cranial neuropathy 2) Right-sided vestibular schwannoma 3) Right vestibular nucleus infarction 4) Right anterior inferior cerebellar artery distribution stroke A... | Abnormal VOR; Jerk Nystagmus; Vestibular Nystagmus; Gaze Evoked Nystagmus; Bruns Nystagmus; Cerebellar OMS |
| 48 |
|
Test Your Knowledge: The Acute Vestibular Syndrome with Gaze-Evoked Nystagmus and Bilaterally Abnormal Head Impulse Testing Due to Middle Cerebellar Peduncle and Flocculus Hemorrhage | This is a 70-year-old woman with a history of atrial fibrillation on warfarin presenting with acute prolonged vertigo and imbalance. In addition to the findings demonstrated in the first part of the video, what else should be seen to reassure the examiner that the etiology of her vertigo is benign? ... | Abnormal VOR; Jerk Nystagmus; Acute Vestibular Syndrome; Cerebellar OMS; Gaze Evoked Nystagmus |
| 49 |
 |
The Acute Vestibular Syndrome in MS Due to Middle Cerebellar Peduncle/Root Entry Zone Lesion | This is a 13 year-old girl with relatively abrupt onset vertigo and oscillopsia. On exam, there was primarily right-beating nystagmus in primary gaze with a slight upward (upbeat) component, giving the nystagmus an oblique appearance. The upward component and lack of a clear torsional component acut... | Jerk Nystagmus; Vestibular Nystagmus; Vestibulo-ocular Reflex; Head Impulse Testing; Gaze-evoked Nystagmus |
| 50 |
 |
The Acute Vestibular Syndrome with Skew Deviation, Gaze-evoked Nystagmus, and Bilaterally Abnormal Head Impulse Testing Due to AICA Stroke | This is a 60-year-old man with the acute onset of prolonged vertigo and nystagmus, consistent with the acute vestibular syndrome (AVS). HINTS (Head Impulse, Nystagmus, Test of Skew) exam demonstrated a central pattern: 1) Head impulse test (HIT) was abnormal to the right and to the left. An abnormal... | Abnormal VOR-HIT; Abnormal Alignment; Skew; Jerk Nystagmus; Gaze Evoked Nystagmus; Acute Vestibular Syndrome; Seventh Nerve; OMS Pons; OMS Cerebellar |