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TitleDescriptionSubject
1 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
2 Eyelid retraction, pseudoabducens and upgaze palsy due to a mesodiencephalic hemorrhageThis is a 70-yo-man who suffered a right midline thalamic/rostral midbrain hemorrhagic stroke causing a pretectal (Parinaud's) syndrome. There was prominent eyelid retraction (Collier's sign), a left pseudo-abducens, and upgaze palsy with convergence retraction nystagmus. There was no light-near dis...OMS Mesenecephalon, Convergence Reaction Nystagmus, Upgaze Palsy, Abnormal Range, Sixth Nerve Palsy, Vertical Gaze Palsy, Eyelid Retraction, OMS Dorsal Midbrain
3 Ocular motor signs in progressive supranuclear palsy (PSP)This is a 65-yo-woman complaining of imbalance and double vision. She had significant convergence insufficiency (and would close her right eye with near viewing), providing an explanation for her diplopia. Convergence insufficiency is very common with parkinsonism. She had bradykinesia and rigidity,...Abnormal Pursuit, Abnormal Range, Upgaze Palsy, Downgaze Palsy, Mesencephalon, Square Wave Jerks
4 Parinaud's syndrome in a man with GBM of the pineal glandThis 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) syndrome were present including: upgaze palsy, convergence retraction nystagm...Saccades; Convergence; Range; Dorsal midbrain syndrome; Convergence retraction nystagmus; Upgaze palsy
5 Test Your Knowledge - Vertical saccadic palsy due to bilateral riMLF infarctionsThis is a 30-year-old who was found minimally responsive on the lounge floor of an ice skating rink. He was brought to the ED, where he had a GCS score of 8 (where 15 is normal) for poor responsiveness. His ocular motor exam is shown in the video.; ; Regarding Finding #1, which of the following is f...Abnormal Saccades, Normal Optokinetic, Abnormal Range, Vertical Gaze Palsy, Upgaze Palsy, Downgaze Palsy, Mesencephalon, Ocular Motor
6 Test your knowledge - Parinaud's syndrome in neurosarcoidosisWatch the first segment of the video up to "Stop! What would you expect with vertical gaze?" and select the best response below. The patient also has mild right-beating nystagmus which can be ignored for the purposes of this question. ; A.; The patient has pupillary findings consistent with bilatera...Normal Convergence, Vertical Gaze Palsy, Upgaze Palsy, Dorsal Midbrain, Mesencephalon, Convergence Retraction
7 Vertical gaze palsy and saccadic intrusions due to anti-Ri from head and neck carcinomaA 55-yo- woman was admitted for imbalance and double vision. Three weeks prior to presentation she first noticed swelling on the right side of her face and neck. CT of the head and neck showed right-sided cervical adenopathy and enlarged left retropharyngeal node. Ultrasound- guided biopsy of the n...OMS Mesencephalon, Square Wave Jerks, Upgaze Palsy, Downgaze Palsy, Abnormal Range, Skew, Vertical Gaze Palsy
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