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TitleDescriptionSubject
1 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
2 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
3 Horizontal Gaze Palsy, Facial Nerve Palsy, and Nystagmus Due to Dorsal Pontine IschemiaPresented 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. His exam was significant for a right horizontal gaze palsy due to right 6th nu...One and half syndome; Horizontal gaze palsy; Pons; Jerk nystagmus; Upbeat nystagmus; Gaze evoked nystagmus; Facial nerve palsy; Internuclear ophthalmoplegia
4 Medial longitudinal fasciculus syndrome with prominent spontaneous nystagmusThis is a 60-year-old man who experienced the abrupt onset of diplopia and imbalance. He had typical features of a left medial longitudinal fasciculus (MLF) syndrome including left internuclear ophthalmoplegia (INO) and left hypertropia from skew deviation, but he also had very prominent upbeat-tors...INO, Jerk Nystagmus, Upbeat Nystagmus, Rotary Nystagmus, Skew Deviation, OMS Pons, Abnormal Alignment, Abducting Nystagmus
5 Medial medullary syndromesThis is a video of two patients who suffered small strokes involving the right medial medulla, and who presented with acute vertigo and oscillopsia. The first patient in the video had pure upbeat nystagmus, while the second patient had upbeat-torsional (towards the right ear) nystagmus in addition t...Medulla; Jerk Nystagmus; Upbeat Nystagmus; Gaze Evoked Nystagmus; Vestibular Nystagmus; Acute Vestibular
6 Nystagmus due to paraneoplastic (anti-Yo) brainstem and cerebellar degenerationThis is a 40-yo-woman with anti-Yo antibody associated with ovarian cancer. Initial symptoms 2.5 years prior (to this video) included imbalance and dysarthria. She complained of oscillopsia which was due to her upbeat nystagmus (presumably the result of brainstem involvement), and diplopia (she had ...Abnormal Saccades, Abnormal VORS, Cerebellar, Jerk Nystagmus, Upbeat Nystagmus, Gaze Evoked Nystagmus,
7 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...One-and-a-half syndrome; Horizontal gaze palsy; Pons; Jerk nystagmus; Upbeat nysagmus; Facial nerve palsy; Internuclear ophthalmoplegia
8 Reversal of vertical nystagmus with convergence in anti-DPPX encephalitisThis is a man who initially presented with spontaneous upbeat and torsional nystagmus, which led to the diagnosis of anti-DPPX encephalitis (for further details on this patient's course and for a video of his nystagmus, see reference 1). Over 6-12 months, his spontaneous (mainly) upbeat nystagmus (U...Upbeat Nystagmus; Downbeat Nystagmus; Jerk Nystagmus; Gaze-Evoked Nystagmus
9 Skew deviation and spontaneous nystagmus due to posterior fossa lesionsThis is a 50-year-old woman who reported the abrupt onset of imbalance, right upper extremity incoordination and binocular vertical diplopia several months prior to her presentation to our clinic. On examination, she had a left hypertropia that was fairly comitant (measuring 5 prism diopters) assoc...Abnormal Alignment, Jerk Nystagmus, Upbeat Nystagmus, Vestibular Nystagmus, Rotary Nystagmus, Skew Deviation
10 Spontaneous upbeat nystagmus in acute Wernicke's encephalopathyThis is a 40-year-old woman presenting with imbalance, confusion and oscillopsia. Exam demonstrated upbeat nystagmus (UBN) in primary gaze that remained UB in all directions of gaze, with a slight torsional component (top poles beating toward right ear) in certain directions of gaze. Her nystagmus f...Upbeat Nystagmus, Jerk Nystagmus, Medullar OMS
11 Test Your Knowledge - The acute vestibular syndrome and ptosisWhat is the most likely localization in this patient presenting with vertical diplopia and acute onset prolonged vertigo? ; A.; Right medial longitudinal fasciculus (MLF); B.; Left medial longitudinal fasciculus ; C.; Right medulla; D.; Left medulla; E.; Left midbrain; ; A.; Incorrect. A right MLF l...Jerk Nystagmus, Acute Vestibular Syndrome, Vestibular Nystagmus, Skew Deviation, Upbeat Nystagmus, Torsional Nystagmus, Rotary Nystagmus, Horner Syndrome
12 Test Your Knowledge - Vertical-torsional nystagmusQuestion #1:; Watch the first portion of the video until you are told to stop. Is this vestibular nystagmus more likely to be peripheral or central? ; A.; Peripheral ; B.; Central ; Answer for #1:; A.; Incorrect. While the patient has upbeat-torsional (top poles beating toward the right ear) nystagm...Jerk Nystagmus, Rotary Nystagmus, Upbeat Nystagmus, INO, Skew, Abnormal Alignment, Abnormal Saccades, Vestibular Nystagmus, Acute Vestibular Syndrome
13 Upbeat and downbeat nystagmus due to anti-VGCC antibodiesSeen here are two patients who presented with imbalance and vertical oscillopsia, the first with upbeat nystagmus, and the second with downbeat nystagmus. Both patients were found to have voltage-gated calcium channel antibodies in serum without evidence of systemic malignancy. The UBN patient had m...Jerk Nystagmus, Upbeat Nystagmus, Gaze Evoked Nystagmus, Downbeat Nystagmus
14 Upbeating and gaze-evoked nystagmus, V-pattern esotropia from bilateral 4th nerve palsiesUpbeat Nystagmus, Gaze Evoked Nystagmus, Fourth Nerve Palsy
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