NOVEL - Daniel Gold Collection
 
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TitleDescriptionSubject
1 + HIT, + Skew, Unidirectional Nystagmus: Central Acute Vestibular Syndrome Due to Wallenberg SyndromeThis is a 45-year-old woman who presented to the ED with acute prolonged vertigo and vertical diplopia. She was seen as an outpatient 1 month after her ED visit, and double vision and balance were improving by that time. Her HINTS testing showed the following (seen in the video): 1) Head Impulse - A...VOR HIT Abnormal; Abnormal Alignment; Skew; Jerk Nystagmus; Vestibular Nystagmus; Acute Vestibular Nystagmus
2 3rd Nerve Palsy With Preserved 4th Nerve Function80-yo-woman with a left vasculopathic 3rd nerve palsy (minimal pupil involvement of about 1 mm relative mydriasis OS - other etiologies ruled out and resolved as expected over months). Although the inferior rectus is paretic, intact superior oblique muscle function can be demonstrated by asking the ...Third (Oculomotor) Nerve Palsy; Third subnuclear
3 6th Nerve Palsy as Initial Presentation of Metastatic Lung CancerA video describing 6th nerve palsy as initial presentation of metastatic lung cancer.Sixth Nerve Palsy; Lung Cancer; Metastatic Cancer
4 A 'Canal Jam' During Head Impulse Testing in a Patient With Horizontal Canal BPPVA 70-year-old man reported brief episodes of positional vertigo. Ten years prior, he had undergone gamma knife radiosurgery for a vestibular schwannoma at the left cerebellopontine angle. Video head impulse testing (vHIT) showed reduced gains and corrective saccades in the planes of the left horizon...Jerk Nystagmus; PC BPPV; HC BPPV Diagnosis; Vestibular Nystagmus; Eighth Cranial Nerve; Vestibulocochlear Nerve
5 A Comparison of Nystagmus and Saccadic Intrusions/OscillationsNystagmus can be classified into pendular and jerk waveforms, where both are generated by a slow, pathologic phase. Corrective phase (the position reset mechanism) differs. In pendular nystagmus, the eyes move back and forth with about the same velocity and amplitude, similar to that of a pendulum...Jerk Nystagmus; Flutter; Pendular Nystagmus; Square Wave Jerks; Opsoclonus
6 A flowchart approach to nystagmus/intrusionsIn tandem with the flowchart, the following added clues should be used to help with etiology: i) vector [horizontal, vertical, torsional]; ii) binocular or monocular; iii) spontaneous or provoked [e.g., BPPV]; iv) change with monocular viewing or gaze direction; v) rest of history, neurologic, and o...Primary subjects of the item, or main keywords: Nystagmus, saccadic intrusions, abnormal eye movements, neuro-otology, neuro-ophthalmology
7 Aberrant Regeneration of the 3rd NerveAberrant regeneration in two patients: 1) a young woman with a right cavernous sinus meningioma with subsequent development of aberrant regeneration demonstrated by eyelid elevation OD in attempted downgaze (i.e., some fibers that were supposed to innervate the right IR were misrouted to the right l...Third (Oculomotor) Nerve Palsy; Third Aberrant
8 Abnormal Active Head Impulse Testing Recorded Asynchronously in Bilateral Vestibular LossThis is a video of patient with the subacute onset of head movement-dependent oscillopsia due to bilateral vestibular loss (with obvious bilaterally abnormal head impulse test (HIT) at the bedside), in addition to central ocular motor signs including saccadic smooth pursuit and gaze-evoked nystagmus...Vestibulo-Ocular Reflex; Head Impulse Testing
9 Abnormal Head Impulse Test in Vestibular Neuritis 1 Week After OnsetThis is a 25-year-old woman who experienced the acute vestibular syndrome due to right-sided vestibular neuritis 1 week prior to this video. Left-beating nystagmus (LBN) was only noted in left gaze, but with fixation-removed, there was clear LBN in primary position that increased with head-shaking a...Abnormal VOR; Vestibulocochlear Nerve; Acute Vestibular Sydrome
10 Abnormal Visually-Enhanced VOR in Cerebellar Ataxia, Neuropathy, Vestibular Areflexia Syndrome (CANVAS)A 67 year old woman presented with 1 year of progressive numbness, gait instability, and oscillopsia when walking or with head movements. Examination showed excessive square-wave jerks, bilateral horizontal gaze-evoked nystagmus, impairment of the visually-enhanced vestibular ocular reflex (vVOR - s...Abnormal Pursuit; Abnormal VOR; Abnormal HIT; Cerebellar; Jerk Nystagmus; Gaze Evoked Nystagmus
11 Abnormal Visually-enhanced Vestibulo-ocular Reflex (vVOR) in Cerebellar Ataxia, Neuropathy, Vestibular Areflexia Syndrome (CANVAS)𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This patient complained of chronic (unexplained cough), progressive numbness in the legs and feet, gait instability, and oscillopsia when walking or with head movements. Examination showed excessive square-wave jerks, bil...Visually-enhanced Vestibulo-ocular Reflex; Cerebellar Ataxia; Neuropathy; Vestibular Areflexia Syndrome
12 Acquired Elliptical Pendular Nystagmus Suppressed by Blinks and Saccades𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 70-year-old man who experienced the gradual onset of oscillopsia over weeks about 3 months prior to this video recording. Examination demonstrated elliptical pendular nystagmus which was atypical for infantile n...Pendular Nystagmus
13 Active Head Impulse TestActive head impulse test (HIT): instruct the patient to fix their eyes on the camera and turn their head 20o to the right/left, and then make a rapid movement toward the midline to align their head with the camera again, keeping their eyes fixed on the camera throughout. A simple instruction is to a...Active Head Impulse Test
14 Acute Vestibular Neuritis With Unidirectional Nystagmus and Abnormal Video Head Impulse Test𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is 45-year-old man who presented to the emergency department (ED) 2 days prior to this video recording with acute onset prolonged vertigo, nausea, head motion intolerance, unsteadiness and spontaneous nystagmus, cons...Jerk Nystagmus; Acute Vestibular Syndrome; Vestibular Nystagmus; Eighth Nerve; Abnormal VOR-HIT
15 Acute Vestibular Syndrome With Skew Deviation and Positive Head Impulse Test Due to a Demyelinating LesionThis is a patient who initially presented with the acute vestibular syndrome (AVS, e.g., acute prolonged vertigo, spontaneous nystagmus). ; See https://collections.lib.utah.edu/details?id=187730 for additional history. ; Her HINTS (Head Impulse, Nystagmus, Test of Skew) testing indicated a central e...VOR HIT; Alignment; Acute Vestibular
16 Acute Vestibular Syndrome with Ocular Tilt Reaction Due to Bacterial LabyrinthitisThis is a patient who initially presented with the acute vestibular syndrome (AVS, e.g., acute prolonged vertigo, spontaneous nystagmus) and right sided hearing loss, and was diagnosed with bacterial labyrinthritis. Her HINTS (Head Impulse, Nystagmus, Test of Skew) testing indicated a central etiolo...VOR HIT; Alignment; Jerk Nystagmus; Vestibular Nystagmus; Acute Vestibular
17 Alternating Hypertropias - Bilateral 4th Nerve Palsies and Alternating Skew Deviation𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: Seen here are two patients with alternating hypertropias. The first is a 70-year-old woman with a diagnosis of cerebellar ataxia, neuropathy, vestibular areflexia syndrome (CANVAS). In the video, both spontaneous downbeat...Skew Deviation; Alignment; Fourth Nerve Palsy; Cerebellar Pathology; Jerk Nystagmus; Downbeat Nystagmus; Gaze Evoked Nystagmus
18 An Approach to the Patient with (Recent Onset) Spontaneous Episodic Vestibular Syndrome𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: A vascular etiology should always be on the differential diagnosis of the recent onset of the spontaneous (unprovoked) episodic vestibular syndrome (EVS), especially in the older population and when vascular risk factors ...
19 An Approach to the Patient with Acute Onset Prolonged Vertigo𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: A vascular etiology should always be on the differential diagnosis of the acute onset prolonged vertigo, especially in the older population and when vascular risk factors are present. However, young patients can suffer fr...
20 An Optokinetic Stimulation Home Exercise Program𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: A plainly written program of optokinetic exercise intended for patient use at home. 𝗡𝗲𝘂𝗿𝗼-𝗼𝗽𝗵𝘁𝗵𝗮𝗹𝗺𝗼𝗹𝗼𝗴𝘆 𝗮𝗻𝗱 𝗡𝗲𝘂𝗿𝗼-𝗼𝘁𝗼𝗹𝗼𝗴𝘆 ...
21 Anterior Canal - BPPV: Deep Head Hanging𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: Regardless or whether it is thought that the patient has right or left anterior canal (AC) involvement, the deep head hanging maneuver is performed in the same way. • First the patient is placed in the long-sitting posi...Benign Paroxysmal Positional Vertigo; BPPV; Anterior Canal; Deep Head Hanging; Exam; Examination
22 Anterior Canal BPPV𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: Although the anterior canal (AC) variant of benign paroxysmal positional vertigo (BPPV) is rare, mainly owing to its orientation relative to gravity (which makes otoconial debris much less likely to enter it), it can occu...BPPV Anterior; BPPV Diagnosis; Jerk Nystagmus; Vestibular Nystagmus
23 Anti-GAD Associated Cerebellopathy and Bilateral VestibulopathyThis is a 70-year-old woman with the subacute onset of severe imbalance and dizziness. On her initial examination, she had prominent gaze-evoked nystagmus and bilateral vestibular loss. Smooth pursuit was saccadic, although her vestibulo-ocular reflex (VOR) suppression was much smoother. Usually pur...Abnormal Pursuit; Normal VORS; VOR Abnormal; HIT Abnormal; Jerk Nystagmus; Gaze Evoked Nystagmus
24 Apogeotropic and Downbeat Central Positional Nystagmus Provoked While SeatedThis is a young man with intermittent complaints of positional vertigo. With Dix-Hallpike and roll testing, he had apogeotropic positional nystagmus (e.g., right beating nystagmus with the left ear down, and left beating nystagmus with the right ear down) in addition to strong downbeat nystagmus in...
25 Approach to the Ocular Motor and Vestibular History and ExaminationHistory and examination of ocular motor and vestibular.Saccades; Ocular Stability; Vestibular Examination
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