151 - 175 of 303
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TitleDescriptionType
151 Oculopalatal Tremor with Prominent Nystagmus, Bilateral Horizontal Gaze Palsy, and Bilateral Facial Palsies𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 50-year-old woman who experienced the acute onset of right sixth and seventh nerve palsies and left hemiparesis. Two cavernomas within the right pons (one in the region of the facial colliculus) were demonstrat...Image/MovingImage
152 One-and-a-Half Syndrome Due to Pontine HemorrhageThis 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 ...Image/MovingImage
153 One-and-a-Half Syndrome, Facial Palsy, and Nystagmus Due to Dorsal Pontine DemyelinationThis is a 16-yo-girl with oscillopsia and double vision. Exam showed inability to look to the left with either eye due to left nuclear 6th. There was also a left INO (horizontal gaze palsy + INO = one-and-a-half syndrome) from left MLF involvement and left lower motor neuron facial palsy due to fasc...Image/MovingImage
154 Opsoclonus Provoked by Convergence𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 40-yo-man with post-infectious opsoclonus-myoclonus syndrome. Opsoclonus was intermittently evident in primary position, but was consistently provoked (and intensified) by convergence. Occasionally, opsoclonus (...Image/MovingImage
155 Optokinetic Nystagmus𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: During the bedside evaluation of optokinetic nystagmus (OKN), the patient is instructed to look at each red (or white) square as it moves past. Because this is not a full-field visual stimuli, using an optokinetic flag m...Image/MovingImage
156 Organic Convergence Spasm and Nystagmus in Posterior Fossa LymphomaThis is a 20-year-old woman, who 9 months prior to this video, first experienced episodes of vertigo and vomiting occurring when lying down or rolling over in bed. Gastrointestinal work-up was unrevealing and MRI was performed which demonstrated "multifocal nodular enhancing lesions along the ependy...Image/MovingImage
157 Oscillopsia and Bilateral Vestibular Loss with Gentamicin OtotoxicityPatients with bilateral vestibular loss commonly experience oscillopsia with head movements, or an inability to stabilize retinal images with subsequent bouncing or jumping of the environment due to loss of vestibular function. This causes significant blurring of vision and disorientation, dizziness...Image/MovingImage
158 Oscillopsia: A Common Symptom of Bilateral Vestibular Loss𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This video is an example of what a patient with bilateral vestibular loss experiences while walking. Without a VOR, there is no mechanism to ensure retinal stability of the world with each head movement, and oscillopsia (...Image/MovingImage
159 PSP with Complete Ophthalmoplegia and Inability to Suppress the VOR𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 65-year-old woman presenting with visual complaints in the setting of advanced progressive supranuclear palsy (PSP). She had complete vertical and horizontal ophthalmoplegia, although the vestibulo-ocular reflex...Image/MovingImage
160 PSP with Vertical Gaze Palsy, Abnormal Optokinetic Nystagmus and Inability to Suppress Blinking to Light𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 75-year-old woman with a diagnosis of progressive supranuclear palsy (PSP). Examination demonstrated vertical supranuclear gaze palsy (i.e., it could be overcome by the vertical vestibulo-ocular reflex [VOR]), s...Image/MovingImage
161 Palato-ocular Synchrony in Oculopalatal TremorThis is a patient with OPT due to a pontine hemorrhage, and although she did have torsional pendular nystagmus, it was very subtle. However, with eyelid closure, much larger vertical ocular oscillations could be seen, which were in fact synchronous with her palatal tremor. This finding, sometimes ...Image/MovingImage
162 Paraflocculus (Tonsillar) Ocular Motor Syndrome and Dysmetria in a Chiari Malformation - Pre and Post-Operative Exams𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 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...Image/MovingImage
163 Paraneoplastic Downbeat Nystagmus and Cerebellar Ataxia Due to Small Cell Lung Carcinoma𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 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 ...Image/MovingImage
164 Parinaud's Syndrome in a Man with GBM of the Pineal Gland𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 60-yo-man who presented with diplopia, headaches, and difficulty looking up, and was found to have a mass involving the pineal gland. Biopsy was diagnostic of a GBM. Major features of Parinaud's (dorsal midbrain...Image/MovingImage
165 Parinaud's Syndrome with Impaired Upward Saccades and Otherwise Normal Vertical Eye MovementsThis is a 50-yo-man who suffered a dorsal midbrain stroke. Exam demonstrated normal vertical range of eye movements, normal vertical VOR and smooth pursuit, but inability to perform upward saccades. Another feature of Parinaud's syndrome seen on his exam was light-near dissociation (not shown in thi...Image/MovingImage
166 Paroxysmal Ocular Tilt Reaction𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 60-year-old woman who 2 years prior experienced a left sided hypertensive hemorrhagic stroke, resulting in right hemiparesis, dysarthria and vertical diplopia. The initial vertical diplopia resolved completely a...Image/MovingImage
167 Pendular Nystagmus𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is an example of pendular nystagmus, where like jerk nystagmus, the slow phase initiates the movement. However, unlike jerk nystagmus, there is no fast phase, but rather back to back slow phases resembling a pendulum...Image/MovingImage
168 Pendular Nystagmus and Ocular Motor Signs in MS𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 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,...Image/MovingImage
169 Pendular Nystagmus and Vision LossThree patients are presented here, each with poor vision (counting fingers or worse) related to retinitis pigmentosa in one patient (Usher's syndrome) and optic neuropathy in two patients, each of whom developed pendular nystagmus after vision loss developed. Visually mediated movements normally pre...Image/MovingImage
170 Pendular, Gaze-Evoked and Abducting Nystagmus in MSThis 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...Image/MovingImage
171 Penlight Cover Test (Partial Removal of Fixation)Penlight cover test (partial removal of fixation): during in-person clinical encounters, the maneuvers below are best tested with complete (or near complete) removal of fixation (e.g., Frenzel or video Frenzel goggles). Removal of fixation is more challenging during virtual evaluations but can be ap...Image/MovingImage
172 Periodic Alternating Nystagmus Due to Nodulus StrokeThis is a 70-year-old woman who experienced the acute onset of vertigo and imbalance. MRI demonstrated a diffusion-weighted imaging hyperintensity involving the nodulus (with corresponding ADC hypointensity) consistent with an acute stroke. On examination several weeks after the stroke, periodic alt...Image/MovingImage
173 Periodic Alternating Nystagmus Due to Spinocerebellar Ataxia Type 6𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 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...Image/MovingImage
174 Periodic Alternating Nystagmus Due to a Chiari MalformationThis patient first experienced oscillopsia 12 months prior to this video. Three months after the onset of symptoms, she was seen by neuro-ophthalmology and found to have a spontaneous, unidirectional left-beating nystagmus (that did not reverse) in addition to saccadic smooth pursuit. Oscillopsia wo...Image/MovingImage
175 Periodic Alternating Nystagmus and Central Head-Shaking Nystagmus from Nodulus Injury𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 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...Image/MovingImage
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