Ординатура / Офтальмология / Английские материалы / The Neurology of Eye Movements_Leigh, Zee_2006

620 Index

Cerebellum (continued)

vergence eye movements and, 298-299, 303 vestibular lesions and, recovery from, 53 VOR adaptation and, 54-56, 55f

Cerebral cortex, in voluntary control of eye movements, 14,233-245

Cerebral hemispheres lesions of

acute, 534-536 focal, 537-542

head turning paresis and, 276-277

ocular motor syndromes caused by, 534-548 unilateral

horizontal nystagmus and, 435-436 large, 536-537, 536t

smooth pursuit and, 181-182, 182f-183f, 184,

436

VOR abnormalities and, 71, 537 saccadic intrusions and, 455 vergence eye movements and, 299

voluntary control of eye movements and, 233-250 descending parallel pathways in, 246-250 frontal lobe in, 242-246

parietal lobe in, 236f, 238-241

posterior cortical areas in, 234-237, 235f, 236f pulvinar in, 241-242

study of, approaches to, 233-234 temporal lobe in, 236f, 237-238

Cervical muscles, viscoelasticity of, head stability and, 265

Cervical vertigo, 469

Cervicocollic reflex, head stability and, 265 Cervico-ocular reflex, 47-48

nystagmus and, 415 purpose of, 267-268

Chiari malformation, 491-492 Children

abducens nerve palsy in, 356

dyslexia in, saccadic eye movements and, 96, 100-101

ocular motor abnormalities in infants, 558-559,

560 vertigo in, 471

Chloral hydrate, 563t Chlordecone, 563

Chordoma, abducens nerve palsy and, 355 Chronic progressive external ophthalmoplegia,

379-381, 379t

Chronic relapsing neuropathies causing ophthalmoplegia, 372

Cigarette smoking, 563-564, 563t Cingulate cortex

gaze control and, 245-246 lesions of, 542

Circularvection, 46 defined,20t

posterior cortical lesions and, 539 Claude's syndrome, 364

Clinical examination, 611-613 of fixation, 177-178

of saccades, 128-129

of smooth pursuit, 178-179

in vestibular disorders, 57-63, 59t bedside caloric testing, 63

dynamic vestibular imbalance tests, 60-61 general principles, 57-58

history-taking, 58-59 positional testing, 60-61

static vestibular imbalance tests, 59-60 vestibular gain testing, 62-63

Clivus tumor, abducens nerve palsy and, 355 Clonazepam

for acquired pendular nystagmus, 458 for downbeat nystagmus, 457-458

for saccadic intrusions and oscillations, 459

Clostridium botulinum, 373 Cocaine, 454t, 563t, 564 Cockayne's syndrome, 559 Coffin-Siris syndrome, 492 Cogan's eyelid twitch sign, 374

Cogan's congenital ocular motor apraxia, 544-546 Cogan's syndrome, recurrent vertigo and, 471 Collier's "tucked lid" sign, 517

Coma, eye movements in, 551-556, 552t, 553f, 555f

Compensation, versus adaptation, 48 Concomitance, spread of, 342 Concomitant deviation

defined,322t

strabismus and, clinical features and diagnosis of, 348-350

Congenital amaurosis, Leber's, 433, 434f-435f Congenital anomalous innervation of extraocular

muscles, 353-355, 354f

Congenital epidermoid tumor, hyperventilation-in- duced nystagmus and, 413, 413f

Congenital extraocular fibrosis, 383 Congenital myopathies, 380

Congenital nystagmus, 276, 345, 442-449, 443d clinical features of, 442-444, 444f

latent nystagmus and, 445-446, 446d pathogenesis of, 444-445

smooth pursuit and, 186 strabismus and, 444 treatment of, 461, 462, 463

Congenital ocular motor apraxia, 98-99, 544-547, 546f

Congenital oculomotor nerve palsy, 363 Conjugate eye movements

cerebellar influences on, 228-233, 229f horizontal. See Horizontal eye movements, conju-

gate

midbrain influences on, 221-228 neural integrator for, 7 physiologic basis for, 336-337 pontine influences on, 215-221

vertical and torsional, brain stem connections for,

220f, 221-228, 224f-225f

voluntary control of, 233-250. See also Cerebral hemispheres, voluntary control of eye movements and

Conjugate gaze deviations, 535d

with acute hemispheric lesions, 534-536 in epileptic seizures, 547, 548

in unconscious patients, 551, 552t, 554 Conjugate gaze palsy, unilateral, internuclear oph-

thalmoplegia and. See One-and-a-half syndrome

Contact lens-spectacle lens combinations for treatment of nystagmus, 461-462

Contextual cues, in VOR adaptation, 51, 52f Contrapulsion, saccadic, 132, 496

Control systems analysis

of smooth pursuit, 174-177 in study of eye movements, 15

Convergence accommodative-linked, 288t

lid nystagmus and, 308, 449, 486 ocular motorneurons during, 296, 296f saccades and, 293, 294f

Convergence-induced nystagmus, 308 Convergence insufficiency, 307

Convergence-linked accommodation, 288t, 292 Convergence-retraction nystagmus, 307

dorsal midbrain syndrome and, 518 Convergence spasm, 308-309

Convergent-divergent nystagmus, 308, 439, 441-442

Convergent-divergent pendular oscillations, 441 Converse bobbing, 552t, 553

COR. See Cervico-ocular reflex

Corneal reflection techniques, for measurement of saccadic eye movements, 129, 614t

Cornelia de Lange syndrome, horizontal saccade failure and, 547

Corollary discharge, 14 Corrective saccades, 10, 98

Corresponding retinal elements, defined, 288t

Corticopontine projections, 249 Corticosteroids

for Cogan's syndrome, 471 for opsoclonus, 459

Counterrolling, ocular, 20t, 21, 22 Cover tests, 340-342, 340f-341f

Cover-uncover test, 340

CPEO. SeeChronic progressive external ophthalmoplegia

Creutzfeldt-Jakob disease, 530, 549 Cristae, anatomy of, 24, 26f

Cross-coupling, of nystagmus, 60-61 Crossed diplopia, defined, 322t

Cupula, 24, 25

Cuppers procedure, for nystagmus,462 Cupulolithiasis, 473, 476. Seealso BPPV

Cyclic oculomotor nerve palsy, 363

Cyclodeviation defined,322t

of superior oblique palsy, 290 Cyclovergence, 290 Cyclovergence nystagmus, 441

Dandy-Walker syndrome, 492 Deiters, ascending tract of, 31 Dementia

AIDS and,549-550

eye movement abnormalities in, 548-550 head nystagmus in, 276

Demyelinative disease. Seealso Multiple sclerosis acquired pendular nystagmus with, 437, 438 internuclear ophthalmoplegia and, 504

Dentatorubropallidoluysian atrophy, 533 Descending parallel pathways

for saccades, 11 If, 118, 249-250 voluntary gaze control by, 246-250, 247f

Descending pursuit pathway, smooth pursuit and, 170,235f

Descending vestibular nucleus, 30, 31

Index 621

Diabetes

abducens nerve infarction and, 356 oculomotor nerve infarction and, 366-367 trochlear nerve infarction and, 359

Diazepam, 459, 561

Diencephalon, lesions of, ocular motor syndromes caused by, 526-528

Diplopia, 287, 321. Seealso Strabismus clinical testing in, 337-344 convergence insufficiency and, 307 crossed, 322t, 339

examination in, 338-344

Bielschowsky head-tilt test, 342-344, 343f cover tests, 340-342, 340f-341f

range of eye movements, 338 subjective testing, 337f, 338-340, 339f

history and, 337-338

in internuclear ophthalmoplegia, 508 monocular, 337

uncrossed, 323t, 339 Dipping, ocular, 552t, 553

Disconjugate adaptation, 304-306, 305f Disconjugate nystagmus, 408

Disjunctive eye movements. See Vergence eye movements

Disparity

fixation, 289, 302

relative versus absolute, 289

Disparity-induced vergence, 12, 287-290, 299-300, 306

Dissociated nystagmus, 408, 506-507

Dissociated vertical deviation (DVD), 350, 427 Divergence

repetitive, 308 saccades and, 293, 294f synergistic, 363

upbeat nystagmus and, 417, 419f Divergence insufficiency, 309

Divergence paralysis, 309-310

Divergence (Cuppers) procedure, for nystagmus,

462

Divergent nystagmus, 308

Arnold-Chiari malformation and, 441

convergent-, 308, 439, 441-442

Divergent pendular oscillations, convergent-, 441 Dix-Hallpike maneuver, 61

for benign paroxysmal positional vertigo, 473-474, 474f-475f

Dizziness. See also Vertigo diagnosis of, 465-466

DNA, mitochondrial, disorders of, 380-381 Dolichoectasia, of basilar artery, 483

Doll's head maneuver, 554 Donders'law, 13,326

Dorsal midbrain syndrome, 517-519, 517t

Dorsal terminal nucleus, optokinetic response and, 173

Dorsal vermis, 23Id

in adaptive control of eye movements, 13 gaze control and, 231-232

lesions of, 122, 232, 489-490, 489d, 490f saccade generation and, 122, 123f saccadic adaptation and, 126

smooth pursuit and, 171

Dorsolateral pontine nuclei, smooth pursuit and, 170

622 Index

Dorsolateral prefrontal cortex, 117, 245d gaze control and, 236f, 244-246 lesions of, 245, 541d, 542

projections of, 248

saccade generation and, 117

Dorsomedial pulvinar, gaze control and, 242 Double elevator palsy, 520

Double vision. See Diplopia

Double-step stimulus motion, saccadic eye movement response to, 99, 99f

Downbeat nystagmus, 70, 416d cerebellum and, 422, 424, 496 clinical features of, 415-416 convergence and, 308 etiology of, 415t

with increasing velocity waveforms, 41 Of, 416, 4l7f

oscillopsia and, 482 pathogenesis of, 421-422, 424 skew deviation and, 465 treatment of, 457-458, 463

Downward eye movements, scheme for, 225f Drug(s). See Medication(s);specific drug Duane's syndrome, 353-355

Duchenne's dystrophy, 379-380 Duction, defined, 322t

Duction test, forced, 338 Duncker illusion, 157

Dynamic overshoots, postsaccade, 94 Dynamic vestibular imbalance, 60-61 Dyslexia

fixation abnormalities and, 101

saccadic eye movements and, 96, 100-101 Dysmetria

cerebellar disease causing, 489-490, 490f clinical examination of, 128 pathophysiology of, 132

pulse, 97, 130

pulse-step mismatch, 97, 130, 13If Dystrophies, muscular, extraocular muscles in,

379-380

Dystrophin, genetic abnormalities of, 379-380

EA-2. See Episodic vertigo and ataxia type 2 EBN (excitatory burst neurons), 104-105 Eccentric rotation

defined,20t

in otolith-ocular testing, 66 VOR gain and, 44-45

Edrophonium test

in Lambert-Eaton myasthenic syndrome, 374 in myasthenia gravis, 375, 376f, 377-378

Efference copy, 14

memory-guided saccades and, 98 smooth pursuit and, 176

spatial localization and, 102 thalamic lesions and, 528

Efferents, vestibular, 29-30 Elderly persons

smooth pursuit responses in, 160, 163-164, 178 square-wave jerks in, 180

vergence eye movements in, 290 vestibulo-ocular reflex in, 42

Electromyography (EMG), 614 myasthenia gravis and, 378 otolith-ocular testing and, 67

Electro-oculography, 129, 614, 615 Encephalitis

brain stem, Bickerstaff's, 372 parainfectious, opsoclonus and, 453

End-point nystagmus, 209, 407, 430-431, 430d EOG (electro-oculography), 129, 614, 615 Epidermoid tumor, congenital, hyperventilation-

induced nystagmus and, 413, 413f Epileptic seizures

eyelid flutter, 547

eye movements during, 547-548, 551, 552, 554

head turning during, 277, 548 recurrent vertigo and, 472 skew deviation and, 465

Episodic ataxias, ocular motor findings in, 493, 494t495t

Episodic vertigo and ataxia type 2 nystagmus and, 430, 459

ocular motor findings in, 493, 495t vertigo and, 472

Epley maneuver, for benign paroxysmal positional vertigo, 474f-475f, 479

Esotropia defined, 322t

induction of, congenital nystagmus and, 444 A or V pattern, 350

thalamic, 308, 527

Ewald's second law, 28, 29, 61, 475-476 Excitatory burst neurons, 104-105 Excyclodeviation, defined, 322t Excyclotropia, 464-465

Exocentric cues, spatial constancy and, 101-102 Exotropia

defined, 322t intermittent, 290

in internuclear ophthalmoplegia, 507 pontine, paralytic, 509

Express saccades, 9It, 96

Extraocular muscle(s). See also specific muscle actions of, 324t

anatomy of, 323-327, 325f-326f

congenital anomalous innervation of, 353-355, 354f

congenital fibrosis of, restrictive ophthalmopathy and,383

discharge rate of, eye movements and, 329, 330f- 331f

fibers of, types of, 327-329, 328f

muscular dystrophies and, 379-380 myasthenia gravis and, 374-375, 376f nontwitch fibers of, 327

paresis of, oscillopsia and, 481-482 pulling directions of, 325-327, 326f structure and function of, 327-331, 328f twitch fibers of, 327

weakening of, for treatment of nystagmus, 462-463

Extraocular proprioception, 329, 332

Eye movements, 3-16. See also specific type, e.g., Vergence eye movements

adaptive control of, 13

analysis of, quantitative approaches to, 37-40, 64-66

dynamic properties of, in paralytic strabismus, 346-348, 348f-349f

fixation-preventing. See Nystagmus; Saccadic intrusions

functional classes of, 4, 4t, 5-6

head movements and. SeeEye-head movements measurement of, 3-4, 4f, 614t

in nystagmus, 409

monocular, in unconscious patients, 552t, 554 range of, assessment of, 338

recordings of, for detection of saccadic abnormali-

ties, 129-130.6141 and spatial localization, 14-15

spontaneous, in unconscious patients, 552-554, 552t

study of

scientific method applied to, 15 value of, 3-5

three-dimensional aspects of, 12-13, 325-327 visual requirements of, 5, 5f

voluntary control of, 13-14, 233-250. Seealso Cerebral hemispheres, voluntary control of eye movements and

Eye position

axis of rotation and, 408-409 central, 13, 322t

in head, 265

neural encoding of, 35 primary, 13, 322t resting

return to, 198, 199f

in unconscious patients, 551-552 in space. See Gaze

Eye-head movements, 11-12 disorders of, 274-278, 275t examination of, 273

laboratory evaluation of, 273-274, 279f in ocular motor apraxia, 545-546, 546f stabilization of head and, 263-265, 264f

disorders of, 275-276, 275t tracking and. See Eye-head tracking

voluntary control of, 265-274 disorders of, 275t, 276-278

rapid gaze shifts and, 265-271, 267f, 268f smooth tracking and, 271-274, 27If

Eye-head saccades, 265-271 adaptive changes of, 268-269 dysmetric, 278

functions of, 265-266

neural substrate for, 269-271 caudal superior colliculus, 270 frontal eye field, 270-271

gigantocellular head-movement region, 269 mesencephalic reticular formation, 270 paramedian pontine reticular formation,

269-270

rostral interstitial nucleus of medial longitudinal fasciculus, 270

in Parkinson's disease, 528-529

saccadic command/VOR interaction in, 267-269, 268f

to unexpected and expected targets, 266, 267f

Index 623

Eye-head tracking, 271-274, 27If

disorders of, 278, 279f examination of, 273

laboratory evaluation of, 273-274, 279f neural substrate for, 272-273

smooth pursuit versus, 279f vestibulo-ocular reflex negation during, 227,

271-272, 27If, 273-274, 279f Eyelid abnormalities

dorsal midbrain syndrome and, 517, 517t myasthenia gravis and, 374

progressive supranuclear palsy and, 523 Eyelid flutter, in epileptic seizures, 547

Eyelid movements, saccades and, 126-128, 127f Eyelid nystagmus, 308, 449, 486

Eye-neck reticulospinal neurons, 270

Facial palsy, abducens nucleus lesions and, 498 Familial episodic vertigo and ataxia type 2

nystagmus and, 430, 459

ocular motor findings in, 493, 495t vertigo and, 472

Familial myasthenic syndrome, 374 Fascia, orbital, anatomy of, 323-325, 324f Fastigial nucleus, 232d

in adaptive control of eye movements, 13 gaze control and, 232-233

lesions of, 122, 123-124, 232-233, 489-490, 489d, 490f

posterior. See Fastigial oculomotor region saccadic adaptation and, 126

smooth pursuit and, 171-172 Fastigial oculomotor region, 122, 232d

gaze control and, 232

lesions of, 489-490, 489d, 490f saccade generation and, 122-124, 123f smooth pursuit and, 171-172 vergence eye movements and, 298

Fatigue nystagmus, 375, 377, 431

FEF. See Frontal eye field

First-degree nystagmus (see Alexander's law),412 Fistula(s)

carotid cavernous

multiple ocular motor nerve palsies and, 370 restrictive ophthalmopathy in, 383

perilymph

ocular tilt reaction and, 464 vertigo and, 469

Fixation

abnormalities of, 180-181 developmental dyslexia and, 101

cerebellum and, 181, 491 clinical examination of, 177-178 defined,11

eye movements during, 5, 5f

gaze stability and, 152-153, 152f-153f laboratory evaluation of, 179-180 latent nystagmus and, 185-186 nystagmus and, 59-60, 180-181

ocular motor neurons during, 200, 200f smooth pursuit versus, 153-156, 154f-155f spasm of, 96, 543

Fixation disparity, 289, 302

624 Index

Floccular target neuron, 31, 53-54, 55-56 Flocculus(i), 230d

compression of, 497

downbeat nystagmus and, 422, 424 gaze control and, 228-231

gaze holding and, 206

lesions of, 55, 71, 171, 230, 487-489, 488d saccadic adaptation and, 126

smooth pursuit and, 171 vergence eye movements and, 298 VOR adaptation and, 53-56, 55f

Flocculo-nodular syndrome, 497, 488d Flutter

eyelid, in epileptic seizures, 547 ocular. See Ocular flutter psychogenic, 455

Forced duction test, 338

Fourth nerve palsy. SeeTrochlear nerve palsy Foveation periods

in congenital nystagmus, 443, 444f in latent nystagmus, 445

Foville's syndrome, 353 Fracture(s)

orbital blowout, 371

temporal bone, vertigo and, 468 Frenzel goggles, 59-60, 612

Friedreich's ataxia, ocular motor findings in, 495t Frontal eye field, 243d. Seealso Frontal lobe(s)

eye-head saccades and, 270-271 gaze control and, 242-244

lesions of, 116, 244, 249, 540, 541d, 542 localization of, 242

pharmacologic inactivation of, 243-244, 249 projections of, 247-248, 247f

saccade generation and, 115-116 smooth pursuit and, 169-170

Frontal lobe(s). Seealso Dorsolateral prefrontal cortex; Frontal eye field

gaze control and, 242-246 Huntington's disease and, 533 lesions of, 96, 528, 540-542, 541d saccade generation and, 115-117

supplemental eye field of. See Supplemental eye field vergence eye movements and, 299

Frontoparietal lesions, ocular motor apraxia and, 542

Functional imaging, cerebral control of eye movements and, 233

Fusion, defined, 288t

Fusional adaptive mechanism, 302-303, 303f Fusional vergence, 12, 287-290, 299-300, 306

GABA. See Gamma-aminobutyric acid Gabapentin

for acquired pendular nystagmus, 458 for macrosaccadic oscillations, 459

Gain. Seealso Pursuit gain; Vestibular gain defined,20t

saccadic, 129-130 Gamma-aminobutyric acid

gaze holding and, 203

vestibular eye movements and, 34, 457 Gap stimulus, saccades made to, 95-96 Gaucher's disease, 558t, 559

Gaze

angle of, 6

cardinal positions of, 322t defined, 265

horizontal. See Horizontal gaze

rapid changes in, eye-head movements and, 265-271, 267f, 268f. See also Eye-head saccades

stability of

disorders of, 275t, 276-278 testing of, 59-60

vestibular loss and, 275-276, 275t visual fixation and, 152-153, 152f-153f

vertical. See Vertical gaze Gaze control, 14

cerebral hemispheres and, 233-250, 237d, 238d, 239d, 24Id, 243d, 245d, 246d Seealso Cerebral hemispheres, voluntary control of eye movements and

dorsal vermis and, 231-232, 23Id fastigial nucleus and, 232-233, 232d midbrain and, 221-227

ponsand,215-221 vestibulocerebellum and, 228-231

Gaze deviations, 535d

with acute hemispheric lesions, 534-536 in epileptic seizures,547, 548

periodic alternating, 552t, 554

in unconsciouspatients, 551, 552t, 554 Gaze holding

abnormal. See Gaze-evoked nystagmus; Rebound nystagmus

clinical evaluation of, 208-209 horizontal, 203-204

medullary lesions impairing, 482-483 neural substrate for, 203-208

cerebellum, 206-207, 206f interstitial nucleus of Cajal, 205-206

NPH-MVN region, 203-205, 205f-206f vertical, 204, 205-206, 223, 225-226

Gaze palsy, horizontal, 499 vertical, 512d complete, 369

Gaze saccades. See Eye-head saccades Gaze-evoked nystagmus, 7, 13If, 410, 41 Of, 429d

cerebellum and, 430, 496 clinical evaluation of, 208-209 clinical features of, 427-430, 429f

end-point nystagmus versus, 430-431, 430d oscillopsia and, 482

pathogenesis of, 209-210 vertical, 210, 227

vestibular imbalance and, 209-210 Gaze-paretic nystagmus, 208, 428-429 Gaze-velocity Purkinje cells, in adaptive control of

eye movements, 54 Gegenrucke (square wave jerks), 449 Gentamicin, ototoxicity of, 481 Geotropic nystagmus,475, 476

Gerstmann-Straussler-Scheinker disease, 549 Giant-cell arteritis, restrictive ophthalmopathy in,

383

Gigantocellular head-movement region, eye-head saccades and, 269

Gilles de la Tourette's syndrome, 533

Glissade, 93-94, 97, 130, 131f

Global effect, saccadic accuracy and, 97 Global fibers, 329

Glycine, 34, 456, 457

GM1 gangliosidosis, horizontal saccade failure and, 547

Goggles, Frenzel, 59-60, 612 Gradenigo's syndrome, 355, 356 Graves' ophthalmopathy, 381-383, 382f

Gray matter, periaqueductal, 227, 519-520 Guillain-Barre syndrome, 371, 372

Habituation, of vestibulo-ocular reflex, 48-49 Hair cells (vestibular), 24, 26f

Harada-Ito procedure, 361 Haw River syndrome, 533 Head

injury of. See Head trauma stability of, 263-265, 264f, 274 disorders of, 275t, 276-278 vestibular loss and, 275-276, 275t

Head movements. Seealso Eye-head movements; Eye-head tracking

examination of, 273 oscillopsia and, 275

rotational. See Head rotation(s) translational. See Head translation(s) vestibulo-ocular response to, 8-9, 8f-9f visual acuity and, 480-481

voluntary control of, disorders of, 276-278 Head nodding, in spasmus nutans, 448 Head nystagmus. See Vestibulocollicreflex

Head oscillations, congenital nystagmus and, 444 Head position

nystagmus and, 475

in spasmus nutans, 447 vestibular perception of, 56

Head pursuit. SeeEye-head tracking Head rotation(s), 21-22, 263, 263f

active, 66 eccentric

in otolith-ocular testing, 66 VOR gain and, 44-45

in pitch, 263, 263f, 264, 265 in roll, 22, 263, 263f

sustained, vestibulo-ocular response to, 9-10, 9f, 23

in unconscious patients, 554-555 in yaw, 263, 263f, 264

Head saccades. See Eye-head saccades Head shaking nystagmus, 60-61, 412 Head thrusts

acute peripheral vestibulopathy and, 467 dynamic vestibular imbalance and, 61

in ocular motor apraxia, 545-546, 546f Head tilt(s), 22, 275

ocular tilt reaction, in, 275-276 complaints of, history-takingin, 58-59

skew deviation and, 71 strabismus and, 346 versus translation, 43, 43f

in Wallenberg's syndrome, 486-487 Head translation(s), 21-22

axes of, 263

Index 625

sustained, vestibulo-ocular response to, 23 versus tilts, 43, 43f

Head trauma

oculomotor nerve palsy due to, 367 ophthalmoplegia and, 371 positional vertigo and, 477

trochlear nerve palsy due to, 357-359 vertigo and, 468

Head tremor, 276 Head turn(s)

congenital nystagmus and, 444 in epileptic seizures, 277, 548 paresis of, 276-277

strabismus and, 345-346 Headache, migraine

ophthalmoplegic, 363 recurrent vertigo and, 470, 471

Head-tilt test

Bielschowsky, 342-344, 343f physiologic basis of, 343-344

Hearing loss, Meniere's syndrome and, 470 Heimann-Bielschowsky phenomenon, 433, 435 Hemianopia, occipital lobe lesions and, 537-538 Hemidecortication, 537

Hemi-seesaw nystagmus, 426, 428, 428d, 428t, 435 Hemorrhage

caudate, 533 cerebellar, 497

midbrain, vertical gaze palsy with, 518-519, 520f521f

thalamic, 527

vestibular organ, recurrent vertigo and, 472 Hennebert's sign, 469

Hepatic encephalopathy, periodic alternating gaze deviation and, 554

Hereditary ataxias, ocular motor findings in, 492-496, 494t-495t

Hering's law, 336

Herpes zoster, acute vertigo caused by, 467-468 Hess screen test, 339

Heterophoria

accommodative vergence testing and, 306 cover test for, 340f, 341

defined,322t Heterotropia

cover test for, 340, 340f defined,322t

Hexosaminidase A deficiency, adult-onset, 558t, 559 Hindbrain, developmental anomalies of, 491-492 Hippocampus, lesions of, 539

History taking

diplopia and, 337-338 nystagmus and, 407

in vestibular disorders, 58-59 HIV/AIDS

dementia and, 549-550 ophthalmoplegia and, 369

Homonymous hemianopia, eye movements and, 101,537

Horizontal eye movements conjugate

brain stem connections for, 215-221, 216f, 218f internuclear ophthalmoplegia and, 221

NPH-MVN lesions and, 203, 205f pontine lesions and, 497-502

dorsal midbrain syndrome and, 518

626 Index

Horizontal eye movements (continued). fusional, 287-289

progressive supranuclear palsy and, 523, 524f525f

Horizontal gaze

midbrain paresis of, 520 paralysis of

acquired, 352-353, 352t

pontine disease and, 497-502, 500f-501f pseudo-horizontal gaze palsy, 510

unilateral, internuclear ophthalrnoplegia and. See One-and-a-half syndrome

Horizontal gaze holding, 203-204 Horizontal saccades

back-to-back, pathophysiology of, 133 burst neurons for, 103-104

failure of, disorders associated with, 547 models for, 106-107, 108f

slow, pathophysiology of, 131, 132 Horizontal semicircular canals, 33-34 Horizontal smooth pursuit

anatomical scheme for, 235f

asymmetric impairment of, 181-182, 182f-183f, 184 Horizontal strabismus, 349-350

Human immunodeficiencyvirus. SeeHIV/AIDS Huntington's disease, 53Id

antisaccades in, 532f clinical findings in, 531-532 diagnosis of, 533 pathogenesis of, 532-533

saccade initiation in, 132-133 Hydrocarbons, exposure to, 563 Hydrocephalus

dorsal midbrain syndrome and, 518 obstructive, pretectal pseudobobbing and, 442 trochlear palsy and, 359

Hypermetric saccades, 97, 132

in myasthenia gravis, 376f, 377, 378 Hyperosmolar coma, opsoclonus and, 454-455 Hypertension, oculomotor nerve infarction and, 365 Hypertropia

defined, 322t

skew deviation and, 463 Hyperventilation, nystagmus caused by, 62,

412-414, 413f Hypometric saccades, 97, 13If, 132

Hypotropia, skew deviation and, 464. Seealso Ocular tilt reaction

IBN (inhibitoryburst neurons), 104 Immunoadsorption therapy, for opsoclonus, 459 Immunoglobulin therapy, for opsoclonus, 459 INC. See Interstitial nucleus of Cajal Incyclodeviation, defined, 322t

Infant(s). See also Children

ocular motor abnormalities in, 558-559, 560 Infections, acute vertigo caused by, 467-468 Inferior cerebellar artery, infarction in the distribu-

tion of, 487, 487f, 496 Inferior oblique muscle, 323-324, 324t

overactivity of, 323-324, 324t paralysis of, 363

Inferior olivary nucleus, 228 oculopalatal tremor and, 439, 483

Inferior parietal lobule, gaze control and, 238, 239 Inferior pulvinar, gaze control and, 241-242 Inferior rectus muscle, 323, 324t, 326

paralysis of, 363

Inferior vestibular nerve, 25 Inferior vestibular nucleus, 31, 32

Inflammatory disorders, recurrent vertigo and, 468t, 471

Infrared differential limbus reflection technique, 614,615

Inhibitory burst neurons, 104

Inner ear disease, recurrent vertigo and, 471 Intermittent deviation, in unconscious patients, 551 Intermittent exotropia, 290

Internal auditory artery, 24-25

Internal medullary lamina, saccade generation and, 119

Internuclear ophthalrnoplegia, 7, 503d, 502-509 bilateral, 508

clinical features of, 503 etiology of, 503-504, 504t, 505f

horizontal conjugate eye movements and, 221 multiple sclerosis and, 556-557

pathogenesis of, 504, 505f, 506-509, 506f pseudo-, myasthenia gravis and, 375 saccadic abnormalities in, 13If

saccadic adaptation after, 125 skew deviation and, 465, 507-508

unilateral conjugate gaze palsy and. SeeOne-and- a-half syndrome

variants of, 508-509

vergence eye movements and, 298, 507 Interstitial nucleus of Cajal, 32f, 226d

gaze holding and, 205-206, 223, 225-226 gaze-evoked nystagmus and, 428, 429 jerk seesaw nystagmusand, 426

lesions of, 225-226, 516d, 516-517 ocular tilt reaction and, 223, 225 skew deviation and, 465

vertical and torsional saccades and, 105 Intracavernous aneurysm, oculomotor nerve and,

365

Intralaminar thalamic nuclei gaze control and, 246d lesions of 527d

Inverse ocular bobbing, 552t, 553 Inverse optokinetic responses, 186 "Inversion" of smooth pursuit, 186

Irritative nystagmus, in Meniere's syndrome, 470 Ischemia, brain stem

horizontal gaze palsy and, 502 positional vertigo and, 477 vertical gaze palsy and, 519t

Isoniazid, for acquired pendular nystagmus,458

Jerk nystagmus,407, 426, 428, 428t

Joubert's syndrome, 492, 558t

Kearns-Sayre syndrome, 380-381, 38It Kernicterus, 558t

Kinocilium, 24 Koeber-Salus-Elschnig syndrome, 517

Korsakoff 's syndrome, 559

Krabbe's leukodystrophy, horizontal saccade failure and,547

Laboratory evaluation

of eye-head movements, 273-274, 279f of smooth pursuit, 179-180

of vestibular and optokinetic function, 63-67, 64t Labyrinth, vestibular

function of, acute unilateral loss of, 466-467, 467d lesions of

bilateral, 70

mechanisms of recovery from, 51-53 unilateral, 67-70

membranous

blood supply of, 24-25 innervation of, 25 structure of, 24, 26f

Labyrinthine artery, 24

Lambert-Eaton myasthenic syndrome, 373-374 Lancaster red-green test, 339-340

Latent nystagmus, 446d clinical features of, 445-446 pathogenesis of, 446-447

smooth pursuit and, 182, 185-186 treatment of, 462

Lateral canal variant of BPPV, 475-476 Lateral semicircular canals, 33-34 Lateral intraparietal area

gaze control and, 240

vergence eye movements and, 299

Lateral medullary infarction. See Wallenberg's syndrome

Lateral pulvinar, gaze control and, 241-242 Lateral rectus muscle, 323, 324t, 326, 328f

Lateral suprasylvian area, vergence eye movements and,299

Lateral thalamic nucleus, ventroposterior, vestibular sensation and, 57

Lateral vestibular nucleus, 31 lesions of, nystagmus and, 71

Lateropulsion, in Wallenberg's syndrome, 124, 484-485, 536

Leaky neural integrator, 201, 202f, 429d cerebellum and, 206-207, 206f

Leber's congenital amaurosis, 433, 434f-435f Leigh's syndrome, 558t, 559-560

Lentiform nucleus, lesions of, 533

Lermoyez syndrome, recurrent vertigo in, 470 Lesch-Nyhan disease, 533-534

horizontal saccade failure and, 547 Levator palpebrae superioris, 126-127, 328 Lewy-body disease, 531

Lid nystagmus, 308, 449, 486. Seealso Eyelid entries Light-near dissociation, 518

LIP neurons, saccade generation and, 118 Listing's law, 13, 109, 290, 326-327 Listing's plane, 325f, 326

Lithium carbonate, 561, 562t Lithium intoxication, 430, 549

Local-feedback model, for saccades, 107, 108f Locked-in syndrome, eye movements during, 554 Long-lead burst neurons, 105-106

Look nystagmus,98

Index 627

Louis-Bar syndrome (ataxia telangiectasia), 558t Lutz, posterior internuclear ophthalmoplegia of,

508-509

Lyme disease, recurrent vertigo and, 471 Lytico-Bodig syndrome, 530

Machado-Joseph disease, 494t

Macrosaccadic oscillations, 133, 450d, 451, 451f, 452f-453f

myasthenia gravis and, 375, 376f, 378 treatment of, 459

Macrosquare-wave jerks, 450d, 451, 45If Maculae, 24, 26f, 28

otolith, physical properties of, 28, 27f Maddox rod test, 339, 339f

Magnetic resonance imaging, internuclear ophthalmoplegia and,504, 505f

Magnetic search coil technique, 129, 409, 614, 615 Main sequence relationship, for saccades, 91

Mai de debarquement, 472 Maple syrup urine disease, 558t Marcus Gunn jaw winking, 554 Mastoid vibration, 62, 412, 466

Measles, acute vertigo caused by, 467 Medial longitudinal fasciculus, 217d

horizontal conjugate eye movements and, 216, 216f, 217, 218f

lesions of, 221, 227, 502-509, 503d, 504t, 505f506f

bilateral, 508 combined, 509-510

oscillopsia and, 481

rostral interstitial nucleus of. See Rostral interstitial nucleus of medial longitudinal fasciculus

vergence eye movements and, 297-298 Medial rectus muscle, 323, 324t

Medial superior temporal visual area, 237d gaze control and, 234, 235f, 236-237, 236f lesions of, 234, 236, 538d, 539

smooth pursuit and, 167-169 vergence eye movements and, 299—300

Medial vestibular nucleus, 3It, 32f, 33 disease of, 482-483

gaze holding and, 203-205, 205f-206f gaze-evoked nystagmus and, 428, 429 lesions of, 71,221

Wernicke's encephalopathy and, 559, 560f Medication(s)

downbeat nystagmus and, 415, 415t

effects on eye movements of, 561-562, 562t-563t gaze-evoked nystagmus and, 430

for nystagmus, 456-459, 457t opsoclonus and, 454-455

Medullary lesions

nystagmus and, 420, 482-483

ocular motor syndromes caused by, 482-487 Medulloblastoma, 497

MELAS, 381

Memantine, for acquired pendular nystagmus, 458-459

Membranous labyrinth blood supply of, 24-25 innervation of, 25 structure of, 24, 26f

628 Index

Memory-guided saccades accuracy of, 97-98 efference copy and, 98

frontal lobe lesions and, 54Id, 542 thalamic lesions and, 528

Meniere's syndrome, vertigo and, 469, 470 Meningeal processes, oculomotor nerve and, 364 Meningioma, abducens nerve and, 355

MERRF, 381

Mesencephalic reticular formation. Seealso Central mesencephalic reticular formation

eye-head saccades and, 270 saccadic intrusions and, 455

vergence eye movements and, 296-298, 297f Mesencephalon. See Midbrain

Metabolic disorders, ocular motor manifestations of, 558-561,558t

Metabolic encephalopathy, ocular bobbing and, 553 Metastatic tumor deposits, restrictive ophthal-

mopathy in, 383 Methadone, 562, 563t

Methyl-r-phenyl-l,2,3,6-tetrahydropyridine (MPTP), parkinsonism caused by, 530

M-group of neurons

in eyelid movements, 127

vertical eye movements and, 227-228 Microflutter, 452-453, 452f-453f Microsaccades, suppression of, 153

Microvascular decompression, for recurrent vertigo, 472-473

Midbrain. See also specific structures, e.g., Interstitial nucleus of Cajal

burst neurons in, for saccades, 104-105 dorsal midbrain syndrome, 517t

hemorrhage of, vertical gaze palsy with, 518-519, 520f-521f

lesions of

convergence nystagmus and, 441

ocular motor syndromes caused by, 511-526 skew deviation and, 465

paramedian, 520

periaqueductal gray matter of, 227, 519-520 selective cell vulnerabilityin, 521-526, 524f-525f

Midbrain paresis of horizontal gaze, 520

Middle cerebellar peduncle, torsional nystagmus and,491

Middle ear infection, acute vertigo and, 468 Middle temporal visual area, 237d

gaze control and, 234, 235f, 236-237, 236f lesions of, 234, 236, 538d, 539

smooth pursuit and, 164, 166f-167f, 167 vergence eye movements and, 299-300

Migraine ophthalmoplegic, 363

recurrent vertigo and, 470, 471 Millard-Gubler syndrome, 355 Miller Fisher syndrome, 371-372

Mitochondrial DNA disorders, progressive external ophthalmoplegia and, 380-381

MLF. See Medial longitudinal fasciculus Mobius syndrome, 353

Monocular diplopia, 337

Monocular eye movements, in unconscious patients, 552t, 554

Monocular nystagmus, 433

Mononucleosis, acute vertigo caused by, 467

Motion in depth, stimuli for, 289 Motor correspondence, law of, 336

MPTP (methyl-r-phenyl-1,2,3,6-tetrahydropyri- dine), parkinsonism caused by, 530

MRI (magnetic resonance imaging), internuclear ophthalmoplegia and, 504, 505f

MST (medial superior temporal visual area), 237d MT (middle temporal visual area), 237d

Multiple ocular motor nerve palsies, 368-373, 369t Multiple sclerosis

acquired pendular nystagmus with, 437 ocular motor apraxia in, 543-544, 544f-545f ocular motor dysfunction and, 556-558 internuclear ophthalmoplegia and, 504 positional vertigo and, 477

Mumps, acute vertigo caused by, 467 Muscimol

gaze holding and, 203

saccadic eye movements and, 114 vestibular eye movements and, 457

Muscle(s). See Extraocular muscle(s); specific muscle Muscle-paretic nystagmus, 377

Muscular dystrophies, extraocular muscles in, 379-380

MVN. See Medial vestibular nucleus Myasthenia gravis

adaptation and, 377-378

clinical features of, 374-375, 375t, 376f diagnosis of, eye movements and, 378-379 ocular motor findings in, 374-375, 375t

pathophysiology of, 375-378 saccades and, 130, 375, 377, 378 sleep test, 374

treatment of, 379

Myasthenic (Lambert-Eaton) syndrome, 373 Myoclonus

oculopalatal, acquired pendular nystagmus and, 438, 439, 440f, 483

opsoclonus-, 453 vertical, 552t, 553-554

Myopathies, congenital, 380 Myotonic dystrophy, 380 Myotubular myopathy, 380

Narcotics, 562, 563t Nasal-temporal asymmetry

of optokinetic response, 173 smooth pursuit and, 182

Near cells, 299 Near triad, 290-291

defined, 288t spasm of, 308-309

Negative feedback control systems, for smooth pursuit, 174-177, I75f

Neostigmine test, in myasthenia gravis, 378 Neural crest tumors, opsoclonus and, 453-454 Neural integrator, 7

abnormalities of, 209-211

centripetal nystagmus and, 210, 429d gaze-evoked nystagmus and, 208-209, 429d instability, 210

pathogenesis of, 209-210 rebound nystagmus and, 210-211

gaze holding and, 203-208, 205f-206f