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Title | Description | Subject |
126 |
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Figure 80: Vascular Distribution and Anatomy Relevant to the Medial Medullary Syndrome (Supplement) | | |
127 |
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Figure 80: Vascular Distribution and Anatomy Relevant to the Medial Medullary Syndrome (Supplement) | | |
128 |
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Five Common Ocular Motor Signs in Cerebellar Disorders - Saccadic Hypermetria, Saccadic Pursuit & VOR Suppression, Gaze-evoked & Rebound Nystagmus | (1) Saccadic hypermetria - an overshoot of the visual target (2) Saccadic smooth pursuit - due to impaired pursuit and low gain, saccades are needed to keep up with the visual target. This gives it a ‘choppy' appearance. (3) Saccadic vestibulo-ocular reflex (VOR) suppression - another... | Abnormal Saccades; Abnormal Pursuit; Abnormal Vestibulo-ocular Reflex (VOR) Suppression; Jerk Nystagmus; Gaze-evoked Nystagmus; Rebound Nystagmus; Cerebellar Oms |
129 |
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Fixation and Gaze Holding | Fixation and gaze-holding: assess for nystagmus or saccadic intrusions by observing the eyes in primary position. Then instruct the patient to look in each position of gaze, and to hold that position to assess for gaze-evoked nystagmus. In doing so, motility can also be evaluated with both eyes view... | Fixation and Gaze Holding |
130 |
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Gaze-Evoked Nystagmus & Slow Saccades Due to Anti-GAD Antibodies in a Patient with Stiff Person Syndrome | This is a 70-year-old woman with a several year long history of imbalance and stiffness. Exam demonstrated axial and lower extremity stiffness, and ocular motor exam demonstrated gaze-evoked nystagmus (e.g., right-beating in right gaze, left-beating in left gaze, up-beating in up gaze), and mild to ... | Jerk Nystagmus; Gaze-Evoked Nystagmus; Abnormal Saccades |
131 |
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Gaze-Evoked and Centripetal Nystagmus in Creutzfeldt-Jakob Disease | This is a 65-year-old woman who experienced a progressive cerebellopathy over several months. Initially, she presented with mild gait imbalance and positional vertigo, and there was only apogeotropic positional nystagmus (more pronounced in supine roll test compared to Dix-Hallpike) with a very slig... | Jerk Nystagmus; Gaze-Evoked Nystagmus; Rebound Nystagmus |
132 |
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Gaze-Evoked, Rebound, and Centripetal Nystagmus in Cerebellar Degeneration | A 68-year-old female reported a 2-year history of progressive gait imbalance, falls, dizziness and vertical oscillopsia. She described that dizziness and oscillopsia were worst when looking down. There was no family history of ataxia. Composite gaze with fixation was recorded with video-oculography ... | Gaze-evoked Nystagmus; Rebound Nystagmus; Centripetal Nystagmus; Cerebellar Degeneration |
133 |
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Gaze-evoked and Rebound Nystagmus in a Cerebellar Syndrome | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: 30-yo-man with the subacute onset of a cerebellar syndrome. After extensive evaluation and progression, it was thought that this represented an autoimmune process and there was some improvement with immunosuppression. He ... | Jerk Nystagmus; End-gaze Nystagmus; Gaze-evoked Nystagmus; Rebound Nystagmus; Cerebellar Pathology |
134 |
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HINTS 'Plus' Patterns in the Acute Vestibular Syndrome Based on Location | HINTS ‘Plus' patterns in the acute vestibular syndrome based on location | Head Impulse-Nystagmus-Test of Skew; HINTS; Acute Vestibular Syndrome |
135 |
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HINTS Exam and Saccadic Dysmetria in Lateral Medullary Stroke | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 50-year-old who experienced the abrupt onset of prolonged vertigo following chiropractic therapy 2 months prior. Initial work-up included an MRI and MR angiogram - MR-diffusion weighted imaging showed an acute l... | Abnormal Saccades; Acute Vestibular Syndrome; Jerk Nystagmus; Vestibular Nystagmus; Normal VOR; Skew Deviation; OMS Medulla |
136 |
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Head Movement Independent ('Sitting') Oscillopsia - A Common Symptom of Nystagmus and Saccadic Intrusions/Oscillations | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This video is an example of what a patient with spontaneous nystagmus or saccadic intrusions/oscillations experiences visually during the abnormal eye movements - i.e., oscillopsia (illusion of movement of the stationary ... | |
137 |
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Head-Shaking (2-3 Hz) | Head-shaking: instruct the patient to close their eyes and perform active rapid head-shaking at 2-3 Hz for ~15 secs. If a unilateral vestibulopathy is present, head-shaking-induced (contralesional) nystagmus is often provoked, with the slow phase toward the affected ear. With central lesions, the ny... | Head-Shaking (2-3 Hz) |
138 |
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Head-Shaking Nystagmus | Head-shaking nystagmus: With a peripheral lesion, similar to vibration, transiently accentuates vestibular asymmetry when baseline VOR function is asymmetric, central patterns are well described and have localizing value (e.g., causing vertical nystagmus after horizontal head-shaking, horizontal nys... | Nystagmus; Head-shaking Nystagmus; Exam |
139 |
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Head-Shaking Nystagmus - A 'Central' Pattern | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: Evaluating for nystagmus provoked by head-shaking, so-called head-shaking nystagmus (HSN), should be performed in all patients with complaints of dizziness or vertigo, regardless of the chronicity. The maneuver is perform... | Abnormal Head Shaking; Jerk Nystagmus; Vestibular Nystagmus |
140 |
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Head-Shaking-Induced Nystagmus Following Ramsay Hunt Vestibulopathy | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 50-year-old man who experienced the abrupt onset of imbalance, dizziness and left-sided hearing loss 4 months prior to this examination. He was found to have herpetic vesicles in the left external auditory canal... | Vestibular Nystagmus; Head-Shaking; Jerk Nystagmus; Vestibularcochlear; Acute Vestibular Syndrome |
141 |
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Hemifacial Spasm | This is a 45-year-old man with intermittent left facial twitching and eyelid closure for the last 6 months. With observation, spontaneous left facial spasms were seen involving the orbicularis oculi and oris muscles. With voluntary contraction of left facial muscles, with smiling for instance, there... | Facial Nerve |
142 |
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Horizontal Canal - BPPV: BBQ Roll to Treat the Right Side | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: To treat right horizontal canal (HC)-BPPV (each position maintained for at least 30 seconds or until nystagmus and/or vertigo cease): • First the patient is placed in the long-sitting position • Then in a supine posit... | Benign Paroxysmal Positional Vertigo; BPPV; Horizontal Canal; Lempert 360- (Barbeque) Degree Roll Maneuver; Exam; Examination |
143 |
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Horizontal Canal - BPPV: Gufoni for Right Apogeotropic | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: To treat the right apogeotropic (beating towards the sky with right ear down and with left ear down - e.g., left beating nystagmus with right supine roll test or with right ear down; right beating nystagmus with left supi... | Benign Paroxysmal Positional Vertigo; BPPV; Horizontal Canal; Ageotrophic Gufoni Maneuver; Exam; Examination |
144 |
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Horizontal Gaze Palsy, Facial Nerve Palsy, and Nystagmus Due to Dorsal Pontine Ischemia | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: Presented here are two patients with horizontal gaze and facial palsies due to stroke. The first patient is a 60-year-old man who presented with double vision and hemiparesis due to a right dorsal pontine ischemic stroke.... | One-and-a-Half Syndome; Horizontal Gaze Palsy; Pons; Jerk Nystagmus; Upbeat Nystagmus; Gaze Evoked Nystagmus; Facial Nerve Palsy; Internuclear Ophthalmoplegia |
145 |
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Horner's Syndrome with Anhidrosis | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a patient with the onset of ptosis OD years prior, with clear evidence of a Horner's syndrome. Imaging of the oculosympathetic tract was unrevealing. The patient also mentioned that with exercise, the left side of... | Horner's Syndrome |
146 |
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How to Measure Ocular Alignment Virtually | Ocular alignment: the alternate cover test can be performed by instructing the patient to hold their head steady, fix their eyes on the camera (or a more distant target - the closer the fixation target, the more of an exodeviation the examiner will see), and use their cell phone (or a spoon) to occl... | Ocular Alignment |
147 |
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Hyperventilation | Hyperventilation: instruct the patient to breathe rapidly in and out of their mouth for 40-60 seconds. Alkalosis and changes in ionized calcium may improve conduction through an affected segment of 8th cranial nerve due to vestibular schwannoma (https://collections.lib.utah.edu/details?id=1213447) o... | Hyperventilation |
148 |
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Hyperventilation-Induced Downbeat Nystagmus in a Cerebellar Disorder | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 45-year-old woman with a chronic progressive cerebellopathy of unclear etiology (worsening over at least 10 years) characterized by gait and limb ataxia, gaze-evoked nystagmus, saccadic pursuit and vestibulo-ocu... | Hyperventilation; Jerk Nystagmus; Downbeat Nystagmus; Downbeat Nystagmus; Cerebellar Pathology |
149 |
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INOs in Stroke | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This video shows 3 patients with vascular risk factors who suffered strokes of the MLF resulting in unilateral INO in each case. In the second case, INO was diagnosed status post cardiac catherization and MRI was found to... | Internuclear Ophthalmoplegia; Abnormal Saccades; Gaze Evoked Nystagmus; Abducting Nystagmus |
150 |
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Idiopathic Downbeat Nystagmus Exacerbated with Positional Maneuvers | 𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 45-yo-woman with vertical oscillopsia for 6+ months, found to have downbeat nystagmus on examination. She mainly complained of dizziness and oscillopsia when laying down. She was found to have a significant exac... | Downbeat Nystagmus; Jerk Nystagmus; Central Positional Nystagmus |