You've searched: Collection: ehsl_novel_gold
1 - 25 of 96
Number of results to display per page
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 -...VOR HIT Abnormal, Abnormal Alignment, Skew, Jerk Nystagmus, Vestibular Nystagmus, Acute Vestibular Nystagmus
2 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,
3 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,
4 Alternating hypertropias - bilateral 4th nerve palsies and alternating skew deviationSeen 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 nystagmus (DBN) and gaze-evoked nystagmus (GEN) are apparent, in addition to a...Skew Deviation; Alignment; Fourth nerve palsy; Cerebellar pathology; Jerk nystagmus; Downbeat nystagmus; Gaze evoked nystagmus
5 Anterior canal BPPVAlthough 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 occur. Because of the relatively para-sagittal orientation of the AC (more so than ...BPPV Anterior, BPPV Diagnosis, Jerk Nystagmus, Vestibular Nystagmus
6 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
7 Atypical ocular motor features (gaze-evoked nystagmus) in PSPThis is a 70-yo-woman who met clinical and radiologic diagnostic criteria for progressive supranuclear palsy (PSP). Typical ocular motor features of PSP include square wave jerks, hypometric saccades, choppy pursuit/VORS, impaired down>upgaze (supranuclear in origin) and impaired down>upward saccade...Abnormal Saccades, OMS Cerebellar, Jerk Nystagmus, Upbeat Nystagmus, Gaze Evoked Nystagmus
8 Bruns nystagmus due to a cerebellopontine angle tumorThis is a 15-yo-girl who experienced headache and imbalance leading to an MRI which showed a left sided cerebellopontine angle (CPA) tumor. Because of involvement of the left brainstem/cerebellum (e.g., dysfunction of the neural integrator/gaze holding apparatus) by the CPA mass, there was left-beat...Jerk Nystagmus, Gaze Evoked Nystagmus, Vestibular Nystagmus
9 Central (Nuclear) 3rd Nerve PalsiesShown here are two patients with left sided midbrain pathology (hemorrhage and ischemia) which caused damage to the 3rd nucleus. Both of the patients have ipsilateral mydriasis, adduction, supra- and infraduction paresis. Ipsilateral>contralateral ptosis is also present, and localizes to the central...Range of eye movements/motility abnormal; Third nuclear; Upgaze palsy; Downgaze palsy; Mesencephalon; Jerk nystagmus; Rotary nystagmus
10 Central Acute Vestibular Syndrome due to posterior fossa hemorrhageThis is a patient presenting with the acute vestibular syndrome (AVS, e.g., acute prolonged vertigo, spontaneous nystagmus) whose HINTS (Head Impulse, Nystagmus, Test of Skew) testing indicated a central etiology based on negative (normal) head impulse testing (HIT). Nystagmus was unidirectional and...VOR HIT, Alignment, Jerk Nystagmus, Vestibular Nystagmus, Acute Vestibular
11 Central HINTS (with an abnormal head impulse sign) in the acute vestibular syndrome due to lateral pontine/middle cerebellar peduncle demyelinationThis is a 30-year-old man presenting with vertigo, diplopia and mild left facial weakness (not seen in the video). On exam, there was right-beating nystagmus (RBN) in primary gaze that increased in right gaze (in accordance with Alexander's law), and the RBN stayed unidirectional, but lessened, in l...Abnormal Alignment, Vestibulocochlear, OMS Pons, Rotary Nystagmus, Vestibular Nystagmus, Acute Vestibular Nystagmus, Jerk Nystagmus, VOR HIT Abnormal
12 Central positional vertigo and nystagmus in a posterior fossa tumorThis is a 30-year old woman who presented with positional vertigo and vomiting following a concussion related to a car accident 3 months prior. She was initially diagnosed with posterior canal (PC) benign paroxysmal positional vertigo (BPPV), although there was no improvement with Epley maneuvers. T...Vestibular Nystagmus, Jerk Nystagmus, Gaze-Evoked Nystagmus, Central Positional Nystagmus, Cerebellar OMS, Downbeat Nystagmus, Upbeat Nystagmus
13 Cerebellar Ataxia, Neuropathy, & Vestibular Areflexia Syndrome (CANVAS): Impaired visually-enhanced VOR and abnormal head impulse testingA 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...VOR Abnormal, HIT Abnormal, Jerk Nystagmus, Gaze Evoked Nystagmus, Square Wave Jerks
14 Cerebellar degeneration with downbeat nystagmus provoked by convergenceDescription: This is a 70-yo-woman with a progressive gait disorder, diagnosed with cerebellar ataxia. She displayed typical cerebellar ocular motor signs including gaze-evoked nystagmus, choppy pursuit and VOR suppression, and there was very subtle spontaneous downbeat nystagmus, best appreciated w...Convergence Abnormal, Cerebellar pathology, Jerk nystagmus, Downbeat nystagmus
15 Cerebellar eye signs in SCA8This is a 30-yo-man with a diagnosis of SCA 8 who had appendicular and gait ataxia in addition to choppy smooth pursuit and VORS, downbeat nystagmus, saccadic hypermetria, and gaze-evoked nystagmus with rebound nystagmus. He also had an esotropia worse at distance, which is commonly found with cereb...Saccadic dysmetria; Downbeat nystagmus; Gaze-evoked nystagmus; Vestibulo-ocular reflex (VOR) supression; Saccades
16 Chiari malformation causing downbeat nystagmus in lateral gazeThis is a 20-yo-man who presented with oscillopsia in lateral gaze from downbeat nystagmus (DBN). In primary gaze, very subtle DBN was only noted with ophthalmoscopy, but in lateral gaze, prominent DBN was present. Other central ocular motor signs included gaze-evoked nystagmus (GEN) vertically, in ...Jerk Nystagmus, Gaze Evoked Nystagmus, Downbeat Nystagmus
17 Congenital nystagmusPresented here are two patients with congenital nystagmus demonstrating characteristic features including: mixed pendular and jerk nystagmus (usually gaze-evoked) waveforms, stays horizontal even in vertical gaze, suppression with convergence, strabismus and a latent component (common but not always...Jerk Nystagmus, Pendular Nystagmus, Latent Nystagmus, Congenital Acquired Nystagmus
18 Dix-Hallpike maneuver in posterior BPPV with reversal of nystagmus on sitting upThis is a patient with typical posterior canal (PC) benign paroxysmal positional vertigo (BPPV), which is provoked by the Dix-Hallpike maneuver. When the patient is moved into the right Dix-Hallpike maneuver, after a brief latency, upbeat-torsional (towards the lowermost or affected [right] ear) nys...BPPV Posterior, BPPV Diagnosis, Jerk Nystagmus, Vestibular Nystagmus
19 Downbeat (perverted) head shaking nystagmus in a patient with spontaneous torsional nystagmusThis is a 75-year-old woman with vascular risk factors who experienced abrupt onset imbalance and dizziness. Symptoms were maximal at onset, and she denied progression over 6 months. Clinically, it was felt that she had suffered a stroke, although an MRI one months later demonstrated an unremarkable...Torsional Nystagmus; Jerk Nystagmus; Headshaking; Downbeat Nystagmus; Cerebellar Pathology
20 Downbeat nystagmusThis is a 40-year-old man with 2 years of progressive ataxia and oscillopsia. On examination, he had downbeat nystagmus (DBN), an ocular motor finding that is usually (but not always) associated with flocculus/paraflocculus dysfunction, which causes overaction of the anterior canal (upward or anti-g...Downbeat Nystagmus, OMS Cerebellar, Jerk Nystagmus, Vestibular Nystagmus
21 Downbeat nystagmus and cerebellar atrophyThis is a 40-year-old man with 2 years of progressive ataxia and oscillopsia. On examination, he had downbeat nystagmus (DBN), an ocular motor finding that is usually (but not always) associated with flocculus/paraflocculus dysfunction, which causes overaction of the anterior canal (upward or anti-g...Downbeat Nystagmus, OMS Cerebellar, Jerk Nystagmus, Vestibular Nystagmus
22 Downbeat nystagmus and convergence spasmThis is a 60-yo-woman with vertical oscillopsia related to her downbeat nystagmus, and diplopia related to an intermittent esotropia. When the esotropia was present, with versions there were bilateral abduction deficits. With ductions and the vestibulo-ocular reflex, it was apparent that the range o...Convergence-abnormal, Range-abnormal, Sixth nerve palsy, Convergence spasm, Cerebellar pathology, Jerk nystagmus, Downbeat nystagmus
23 Eye signs in infantile esotropia - latent nystagmus and inferior oblique overactionThis is a 25-yo-man with a history of amblyopia and intermittent eye crossing. On exam, he had a comitant 25 prism diopter esotropia, and other features of infantile (or congenital) esotropia including: latent nystagmus (right-beating nystagmus with occlusion of the left eye and left-beating nystagm...Jerk Nystagmus, Latent Nystagmus, Abnormal Range, Assessing Abnormal Alignment
24 Gaze-evoked and centripetal nystagmus in Creutzfeldt-Jakob diseaseThis 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
25 Gaze-evoked and rebound nystagmus in a cerebellar syndrome30-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 had a variety of cerebellar ocular motor findings, including gaze-evoked nystag...Jerk nystagmus; End-gaze nystagmus; Gaze-evoked nystagmus; Rebound nystagmus; Cerebellar pathology
1 - 25 of 96