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1 Daroff_02-14Accomodative Gaze Palsy or Convergence SpasmThis is a psychogenic disorder that may mimic lateral rectus palsy. The clue is pupillary constriction during attempted lateral gaze.Accomodatitve Gaze Palsy; Convergence Spasm; Eye Movement Disorders; Spasm of the Near Triad
2 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
3 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
4 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
5 Daroff_02-3Bilateral Horizontal Gaze PalsyA patient with a bilateral PPRF lesion displays intact vertical gaze and convergence.Bilateral Horizontal Gaze Palsy; Eye Movement Disorders; Horizontal Gaze Palsy
6 Daroff_02-5Bilateral Internulcear OphthalmoplegiaA woman with a bilateral INO demonstrates impaired adduction and nystagmus of the abducting eyes. Her vertical gaze is intact. The dissociated optokinetic nystagmus, due to an inability of the medial recti to generate normal saccades, is again shown.Bilateral Internulcear Ophthalmoplegia; Nystagmus; Internuclear Ophthalmoplegia
7 Daroff_Tape-2Brain Stem Eye Movement SyndromesIn this series, the importance of the brainstem in eye movements is discussed, with particular emphasis is placed on the signficance of the paramedian pontine reticular formation (PPRF), the medial longitudinal fasciculus (MLF), and the nuclei and projections of cranial nerves III and VI. Correlat...Brain Stem; Eye Movement Disorders
8 Daroff_Tape-3Cerebellar Eye SignsLesions of the cerebellum can result in a variety of eye movement disorders, including saccadic intrusions and oscillations, such as ocular dysmetria, as well as nystagmus, gaze palsies, and dysfunction of the vestibular ocular reflex. In this series of videos, these disorders are discussed in rela...Cerebellar; Eye Movement Disorders; Cerebellar Pathology
9 Daroff_03-1Cerebellar Eye Signs: OverviewThe wide array of cerebellar eye signs, includes, among others, saccadic intrusions and oscillations, nystagmus, gaze palsies, and impairment of the vestibulo-ocular reflex.Eye Movement Disorders; Cerebellar Eye Signs; Olivopontocerebellar Degeneration
10 Daroff_Tape-1Cerebral Control of Eye MovementsIn this series, the purpose and nomenclature of eye movements are described, with the anatomical pathways generating and controlling the cortically-driven movements -- saccades and smooth pursuit in horizontal gaze, upgaze and downgaze -- discussed in detail. The importance of each of the three sac...Cerebellar; Eye Movement disorders; Supranuclear Input; Optokinetic Nystagmus
11 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
12 Daroff_02-7Classifications of Internuclear OphthalmoplegiaBoth the Lutz and Cogan classifications of INO separate them into anterior and posterior varieties. The Cogan classification, which depends upon the presence or absence of convergence, is not particularly useful for localization. The Lutz posterior INO, which is a supranuclear pareses of abduction, ...Internuclear Ophthalmoplegia
13 Daroff_01-4Defective PursuitA patient with a cerebral hemispherectomy manifests ipsilateral low-gain (saccadic) pursuit, and impaired optokinetic nystagmus when the targets are moved towards the lesioned side. The multiple causes of pursuit abnormalities are discussed.Eye Movement Disorders; Smooth Pursuit Deficiencies; Pursuit
14 Daroff_01-6Defective Saccades: Frontal Lobe LesionA patient with a right frontal lobe infarction demonstrates loss of saccades to the left with preservation of pursuit.Saccades; Saccadic Eye Movements; Eye Movement Disorders; Frontal Lobe Lesion
15 Daroff_01-5Defective Saccades: Slow to No SaccadesIn 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.Saccades; Saccadic Eye Movements; Eye Movement Disorders
16 Daroff_03-4Downbeat NystagmusPrimary position downbeat nystagmus is demonstrated, with a list of the common causes.Downbeat Nystagmus
17 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
18 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
19 Daroff_02-10Gaze Evoked Ear RetractionLarge 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."Gaze Evoked Ear Retraction
20 Daroff_02-9Gustatory Lid Retraction in Congenital Horner's SyndromeA young girl with unilateral ptosis from a congenital Horner's syndrome demonstrates a distinctively rare phenomenon of resolution of the ptosis by sucking lemon juice.Horner Syndrome; Lid Retraction
21 Daroff_02-2Horizontal Eye MovementsThe 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 ...Horizontal Eye Movements; Frontal Eye Fields; Paramedian Pontine Reticular Formation (PPRF); Medial Longitudinal Fasciculus (MLF); Oculomotor Cranial Nerves
22 Daroff_02-4Internuclear OphthalmoplegiaLesions 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...Internuclear Ophthalmoplegia
23 Daroff_01-1Introduction to Eye MovementsThis brief clip reveals how eye movements subserve vision, and provides an overview of each of the four eye movement systems: saccadic, smooth pursuit, vergence, and vestibular.Eye Movements; Saccades; Smooth pursuit; Cerebral control of eye movements; Efferent Visual Pathways; Convergence
24 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
25 Daroff_Tape-4Miscellaneous Ocular OscillationsIn this final series, several eye movement abnormalities are detailed with patients used to illustrate each. KEY WORDS: opsoclonus-myoclonus, opsoclonus, square wave jerks, macro square wave jerks, pause cell dysfunction, voluntary nystagmus, eyelid nystagmus, see-saw nystagmus, superior oblique my...Ocular Motility Disorders; Eye Movement Disorders
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