Ординатура / Офтальмология / Английские материалы / Tumors of the Eye and Ocular Adnexa_Char_2001

horizontal nystagmus and, 488, 489f magnetic resonance imaging of, 610f oscillopsia and, 580, 609

treatment of, 538 type I, 609

type II, 609 vertigo and, 562t

Arteritis, giant-cell, 562t Ascending tract of Deiters, 36 Aspartate, 262, 533 Asperger’s syndrome, 673 Asthenopia, 366

Ataxia

familial episodic vertigo and, 500, 533, 562t, 576, 612t Friedreich’s, 165, 220, 608, 612t, 614

hereditary, 611–614, 612t–613t

ocular motor apraxia with, 613t, 666t, 668 spinocerebellar, 39, 153, 370, 611–614, 612t–613t, 628

Ataxia telangiectasia, 613t, 666t, 668, 680t Atelectasis, vestibular, 562t Attention-deficit hyperactivity disorder, 673

Auditory stimuli, Tullio phenomenon with, 70, 481–482, 564–565, 564f

Autism, 673

Autosomal recessive myopathy with external ophthalmoplegia, 445–446

Averbuch-Heller, L., 445 Azathioprine

in brainstem encephalitis, 526 in myasthenia gravis, 444

Baclofen, 685t

in nystagmus, 529t, 531, 532

in periodic alternating nystagmus, 494, 495, 529 in superior oblique myokymia, 427 velocity-storage mechanism and, 39

Balance, loss of, 559. See also Vertigo Balint’s syndrome, 140, 287, 663, 671 Bárány, R., 21

Bárány maneuver, 572 Barbecue-spit rotation, 75, 609 Barbiturates, 622t, 636t, 684t

intracarotid injection of, 656 in nystagmus, 529t

in saccadic hypermetria, 534 vestibulo-ocular reflex effects of, 326

Bardet-Biedl syndrome, 669

Basal ganglia. See also Caudate nucleus; Substantia nigra pars reticulata

lesions of, 161t, 648–654. See also Huntington’s disease; Parkinson’s disease

saccade generation and, 143–145

Basal interstitial nucleus, saccade generation and, 145 Basilar artery

aneurysm of, 430–431 dolichoectasia of, 421, 579, 601

Basilar invagination, 482t Bassen-Kornzweig disease, 666t, 680t, 683 Bechterew’s phenomenon, 77

Becker’s dystrophy, 445

Bedside ocular motor examination, 718–720 Behçet’s disease, 434t, 486t

Bell’s phenomenon, 437, 635

Index 729

Benedikt’s syndrome, 430

Benign paroxysmal positional vertigo (BPPV), 31, 562t, 570–574

anterior canal variant of, 574, 578 bilateral, 574

canalolithiasis and, 570, 573, 574 clinical features of, 570–574, 572f–573f electromyography in, 75, 575

lateral canal variant of, 573, 578 nystagmus in, 9, 77, 481 pathophysiology of, 574–576 posterior canal variant of, 571 surgical treatment of, 578 treatment of, 576, 578

Benign paroxysmal vertigo of childhood, 562t, 567 Benzodiazepines, 525t, 629t, 684t

divergence insufficiency and, 370 in saccadic hypermetria, 534

Benztropine, in nystagmus, 529t, 532 Beta blockers, 685t

Bickerstaff’s brainstem encephalitis, 437 Bicuculline

medial vestibular nucleus injection with, 530 neural integrator inactivation with, 249, 249f superior colliculus inactivation with, 134–135

Bielschowsky, A., 386

Bielschowsky head-tilt test, 407–409, 408f, 719 Binocular vision

abnormal development of, 225 proprioception and, 396

Biofeedback, in nystagmus, 529t, 539 Bitemporal visual field defect, 498 Blepharospasm

essential, 654

in progressive supranuclear palsy, 640 Blindness

cortical, 214, 658 efference and, 196

nystagmus and, 220, 503, 504f Blinks

examination of, 159 frequency of, 157

omnipause cell discharge and, 128 saccades and, 156–158, 158f, 653 slow saccades and, 629

smooth pursuit and, 219 vergence and, 353

Blow-out fracture, ophthalmoplegia and, 436 Blurred vision, strabismus and, 403

Bob, head translations in, 22, 315 Bobbing, ocular, 674–675, 674t, 675f Bobble-head doll syndrome, 331 Bode plot, 41, 42f, 199

Botulinum toxin, 393, 439

in nystagmus, 529t, 536, 537f Botulism, 438, 439f

Bow-tie nystagmus, 486f, 487

BPPV. See Benign paroxysmal positional vertigo (BPPV) Brachium conjunctivum, 35, 272

lesions of, 490 Brainstem

at abducens nucleus, 264f

contrecoup force to, trochlear nerve palsy and, 424 horizontal conjugate eye movements and, 262–268,

263b, 263f, 264b, 264f, 265b, 266b, 266f

730 Index

Brainstem (Continued) lesions of

off-vertical axis rotation and, 39 ophthalmoplegia and, 434t, 435 vertigo and, 562t

vestibular nystagmus and, 490–491

at rostral interstitial nucleus of the medial longitudinal fasciculus, 264f

saccade generation and, 124–135, 125f, 125t, 127f, 130f

section of, at rostral mesencephalon, 269f tumors of, 562t

vertical and torsional conjugate eye movements and, 27b, 268–274, 268b, 269f, 270f, 271b, 273b, 274b vestibulo-ocular reflex elaboration by, 31–39, 31t, 33f

Brainstem encephalitis, 525–526, 534, 629 Brandt-Daroff exercises, 576

Brown’s syndrome, 426 Bruns’ nystagmus, 501, 615

Build-up neurons, saccade generation and, 133–134 Buoyancy hypothesis, 565

Burst neurons collicular, 133–134

excitatory, 125t, 126, 267, 268, 270 gaze, 323

inhibitory, 125t, 126, 265, 632 long-lead, 125t, 129–130 midbrain, 125t, 126–127 neurotransmitters of, 533 ocular, 323

pontomedullary, 125t, 126 premotor, 125, 125t, 126–127, 160t saccadic oscillations and, 528

slow saccades and, 629–630 vergence, 356–357, 357f, 360

Burst-position neurons, 34 Burst-tonic neurons, 276

vergence, 356, 357, 357f, 360

CA/C ratio, 345t, 346, 363 CACNL1A4 gene, 611

Cajal, interstitial nucleus of. See Interstitial nucleus of Cajal

Calcium channel, P/Q voltage-gated, 439, 614 Caloric testing, 561, 720

bedside, 66t, 71

cortical response to, 63–64

perverted vestibular nystagmus with, 488–489 quantitative, 72–73

in unconscious patient, 676

in Wernicke’s encephalopathy, 681, 682 Calyx endings, of hair cells, 31

Campylobacter jejuni, 437 Canal paresis, 72–73 Canalolithiasis, 570, 573, 574 Cancer. See also Tumor

cerebellar degeneration and, 614 Gradenigo’s syndrome and, 421 ocular flutter and, 526 opsoclonus and, 526

Cannabis, in nystagmus, 529t Cannaboid receptors, 37 Carbamazepine, 636t, 684t

in nystagmus, 529t

in ocular neuromyotonia, 438

in recurrent vertigo, 570

in superior oblique myokymia, 427 Cardiac surgery

eye-head saccades and, 333f ocular motor apraxia and, 664

Carotid artery, aneurysm of, 430 Carotid-cavernous fistula, 435

direct, 435 dural, 435 low-flow, 435

oculomotor nerve palsies and, 435 Cartesian coordinates, 152 Cataract, 503–504, 513t Catecholamines, 62

Caudal oculomotor nucleus, 399f, 401 lesions of, 429

Caudate nucleus hemorrhage of, 653

saccade generation and, 143–144, 297 smooth pursuit and, 211

Cavernous sinus, 401 lesions of, 435

abducens nerve palsy and, 418t–419t, 422 multiple ocular motor nerve palsies and, 434t, 435 oculomotor nerve palsy and, 428t, 431–432, 432f trochlear nerve palsy and, 424t

Central adaptation, in myasthenia gravis, 443 Central core myopathy, 446

Central eye position, 386t

Central mesencephalic reticular formation, 642 eye-head saccades and, 323

lesions of, 638, 638b. See also Progressive supranuclear palsy

pharmacological inactivation of, 323 saccade generation and, 129–130, 274, 274b

Central otolithic pathways, lesions of, 272 Central position, 13, 386t

Central positional vertigo, 575–576 Central tegmental tract, 600

lesions of, 628

Central vestibular nystagmus, 482–493. See also Downbeat nystagmus; Torsional nystagmus; Upbeat nystagmus

horizontal, 488, 489f perverted, 488–489 Centripetal drift, 253–254 correction of, 244, 245f

in darkness, 246

in myasthenia gravis, 440

Centripetal nystagmus, 255, 256, 498b, 501, 608 Centronuclear myopathy, 446

Cephalomotor system, 315

Cerebellar arteries, occlusion of, 614–615 Cerebellectomy, 148, 155, 255 Cerebellopontine angle

tumors of, 501 vestibular nerve at, 27

Cerebellum, 13–14, 274–280, 275f. See also Vestibulocerebellum

blinks and, 158

developmental abnormalities of, 609–611. See also Arnold-Chiari malformation

dorsal vermis of. See Dorsal vermis fastigial nucleus of. See Fastigial nucleus flocculus of. See Flocculus

gaze holding and, 249f, 250–251 hemorrhage of, 562t

infarction of, 562t, 614–615 lesions of

eye-head tracking and, 334, 334f gaze-evoked nystagmus and, 254 gaze-instability nystagmus and, 500 head movements and, 332

mass, 562t, 575, 615–616 nystagmus and, 503

ocular bobbing and, 675, 675f

ocular motor syndromes and, 605–616, 605b, 606b opsoclonus and, 527–528

periodic alternating nystagmus and, 495, 495t rebound nystagmus and, 256

skew deviation and, 60, 582 smooth pursuit and, 223

vergence eye movements and, 358–359 vertigo and, 567–568

nodulus of. See Nodulus in ocular motor repair, 503

paraflocculus of. See Paraflocculus paraneoplastic degeneration of, 614

saccade generation and, 145–149, 146f, 147f, 149f saccadic adaptation and, 155–156

smooth pursuit and, 211–212 tumors of, 562t, 575, 615–616

vergence eye movements and, 358–359 vestibulo-ocular reflex adaptation and, 60–62, 61f, 609

Cerebral hemispheres. See also specific cerebral structures

hemidecortication of, 80, 214, 223–224, 656–657 lesions of, 14, 80, 654–670

acute, 654–656, 655b

conjugate deviation with, 656–657 focal, 657–663, 658b, 660b, 661b gaze preference and, 654

smooth pursuit and, 220–223, 221f–222f sternocleidomastoid weakness and, 331 unilateral, 505, 656–567, 656b

vergence eye movements and, 368 saccade generation and, 145

voluntary eye movement control and, 14, 280–293 approaches to, 280–281

cingulate cortex in, 294

descending parallel pathways in, 295–299, 296f dorsolateral prefrontal cortex in, 293–294, 293b frontal eye field in, 289–291, 290b

frontal lobe in, 289–292, 290b, 292b

medial superior temporal visual area in, 283f, 284–285

middle temporal visual area in, 281, 282f, 283f, 284, 285

parietal eye field in, 287–288, 287b parietal lobe in, 286–288, 286b, 287b posterior parietal cortex in, 286–287, 286b pre-supplementary motor area in, 292–293

primary visual cortex in, 281, 282f, 283b–284b pulvinar in, 288–289, 288b

secondary visual areas in, 281, 284–285 supplementary eye field in, 291–293, 292b temporal lobe in, 283f, 285–286, 285b

Ceruletide, in oculopalatal tremor, 600–601 Cervical nystagmus, 482

Cervical vertigo, 482, 563 Cervico-collic reflex, 317 Cervico-ocular reflex, 53, 321

nystagmus and, 482

in unconscious patient, 676

Index 731

Chameleon, 343–344 Chediak-Higashi syndrome, 513t

Chiari malformation. See Arnold-Chiari malformation Children. See also Infant(s)

abducens nerve palsy in, 422 dyslexia in, 120–122

fixation in, 217

phoria adaptation in, 362 saccades in, 115

vestibulo-ocular reflex gain in, 45 Chiropractic manipulation, 562t Chloral hydrate, 685t Chlordecone, 525t, 686

Chordoma, abducens nerve palsy and, 421 Chorea

Huntington’s. See Huntington’s disease Sydenham’s, 654

Chorea-acanthocytosis, 653

Chronic inflammatory demyelinating neuropathy, 437 Chronic progressive external ophthalmoplegia, 444–450

autosomal recessive myopathy with, 445–446

in congenital embryogenesis disorders, 449–450, 449t in congenital extraocular muscle fibrosis, 448–449

in congenital myopathy, 446 differential diagnosis of, 444t in Duchenne’s dystrophy, 445

in Kearns-Sayre syndrome, 446–447, 446t in myotonic dystrophy, 445

in oculopharyngeal dystrophy, 445 in thyroid disease, 447–448, 448f

Cigarette smoking, square-wave jerks and, 523, 672 Cingulate cortex, 293

anterior, 294 lesions of, 294, 663 posterior, 294

saccade generation and, 139–140 smooth pursuit and, 210

voluntary eye movement control and, 294 Cingulate eye field, 139–140, 294 Cingulate gyrus, 63

Circularvection, 21t, 50, 51, 64 subjective, 64

vestibular cortex lesions and, 659 Claude’s syndrome, 430

Clinical examination, 718–720 of fixation, 217, 719

of nystagmus, 476–479, 481 of saccades, 158–159, 720

of smooth pursuit, 217–218, 720 of vergence, 366–367, 720

of vestibular disorders, 66–71, 66t, 719–720 Clivus tumor, 421

Clomipramine, 675 Clonazepam

in nystagmus, 529t, 531, 533 in saccadic hypermetria, 534 in saccadic oscillations, 534

Clostridium botulinum, 438, 439f Cocaine, 525t, 685t, 686 Cochlear artery, 24

Cochlear implants, 562t Cockayne’s syndrome, 505t, 683 Coenzyme Q10, 447 Coffin-Siris syndrome, 611 Cogan, D.G., 108, 605

Cogan, J.J., 108

Cogan’s eyelid twitch sign, 440

732 Index

Cogan’s spasticity of conjugate gaze, 656–657, 656t Cogan’s syndrome, 562t, 567, 666–668, 667f Cognition, eye movement study of, 14, 15f Collier’s tucked lid sign, 635

Colobomata, 513t

Color vision, examination of, 718

Coma, 673–678. See also Unconsciousness hyperosmolar, 525t

Comitant deviation, 386t, 402 Compensation, vs. adaptation, 53fn. Complement, 393

Complement inhibitors, in myasthenia gravis, 442 Concomitance, spread of, 409

Concomitant deviation, 386t, 402

Conditional learning, supplementary eye field and, 137 Cone dystrophy, 513t

Congenital amaurosis, Leber’s, 486t, 503, 504f, 513t, 533 Congenital fibrosis of extraocular muscles, 449–450, 449t Congenital myopathy, 446

Congenital nystagmus, 331, 512–521. See also Fusional maldevelopment nystagmus syndrome; Infantile nystagmus syndrome; Spasmus nutans syndrome

animal models of, 512

clinical features of, 512–516, 513t, 514f, 517b, 519b convergence suppression of, 371–372

head turns in, 411

oscillations in, 191, 193, 514–515 pathogenesis of, 517

pendular form of, 216 quantitative features of, 515–516 smooth pursuit in, 218, 225–226 visual system disorders with, 513t waveform of, 255, 516, 517

Congenital ocular motor apraxia, 118, 332, 666–669, 666t, 667f

Congenital oculomotor nerve palsy, 429–430 Conjugate eye movements, 261–300. See also

specific types of eye movements

cerebellar influences on, 274–280, 275f, 276b, 277b, 278b, 279b

cingulate cortex in, 294 definition of, 345t

dorsolateral prefrontal cortex in, 293–294, 293b horizontal, brainstem connection for, 262–268, 263b,

263f, 264b, 264f, 265b, 266b, 266f physiology of, 401–402

vertical and torsional, brainstem connection for, 267b, 268–274, 268b, 269f, 270f, 271b, 273b, 274b

voluntary control of, 280–299. See also Cerebral hemispheres, voluntary eye movement control and

Connexons, 511, 600

Constant velocity drift, 476f, 479

Contact lenses, in nystagmus, 529t, 538–539 Context, in vestibulo-ocular reflex adaptation, 57 Contrapulsion, 149, 163, 603

upbeat nystagmus and, 490

Contrecoup force, trochlear nerve palsy and, 424 Control systems analysis, 15–16

in smooth pursuit, 215–217

Convergence. See also Vergence eye movements accommodation-linked, 345t, 346–347 congenital nystagmus and, 371–372 impairment of, 361

lid nystagmus and, 372, 571 paralysis of, 358

saccadic oscillations and, 372

Convergence excess, 367, 370–371 Convergence insufficiency, 366, 367, 368 Convergence spasm, 370–371

Convergence-retraction nystagmus, 371, 512, 636 Convergent-divergent nystagmus, 511–512

COR (cervico-ocular reflex), 53, 321, 482, 674 Corectopia, 513t

Corneal opacity, 513t Corneal reflection

in saccade evaluation, 159 in strabismus evaluation, 404

Cornelia de Lange syndrome, 669 Corollary discharge

mediodorsal thalamus and, 137 vs. proprioception, 396 saccades and, 118, 123, 148, 156 smooth pursuit and, 216

Corresponding retinal elements, 344, 345t Cortical area 8a, 63

Cortical area 7a,b, 63, 286–287 Cortical area 3aH, 63

Cortical area 6pa, 63 Cortical blindness, 214, 658

Cortical-basal ganglionic degeneration, 643, 651 Corticopontine projections, 298

Corticosteroids

in brainstem encephalitis, 526 in opsoclonus, 534

Countermanding task, for saccades, 116, 137 Counterrolling, ocular, 21t, 22, 24, 75, 409 Cover tests, 406–407, 406f, 407f, 718 Cover-uncover test, 406–407

Craniocervical junction anomalies, divergence insufficiency and, 370

Craniosynostosis, 415

Craniotopic coordinates, 124, 209, 287 Creutzfeldt-Jakob disease, 486f, 495t, 643, 651, 671 Crista ampullaris, 27–28

Cristae, 26, 26f Cross-axis adaptation, 56

Cross-coupling, of nystagmus, 68–69 Crossed diplopia, 386t, 404

Cross-fixation, in congenital horizontal gaze palsy, 419 Cross-striolar inhibition, 27, 36

Cüppers divergence procedure, 529t Cupula, 26, 28

Cupulolithiasis, 570, 573

Customary ocular motor range, 319–320, 320f Cyclic spasms, oculomotor nerve palsy with, 430 Cyclodeviation, 386t, 423

Cyclopean eye, 344 Cyclosporin-A, 685 Cyclovergence, 351 Cyclovergence nystagmus, 511

Dandy-Walker syndrome, 609, 611

Darwin, C., 402

Darwin, E., 21

Decisional process, 293

De-efferented state, 331, 676

Deiters, ascending tract of, 265

Dell’Osso, L.F., 538

Dementia, 643, 651, 670–671

Demer, J.L., 389

Demyelinating disease. See also Multiple sclerosis internuclear ophthalmoplegia and, 508, 678, 679 pendular nystagmus and, 506b, 507f, 508–509

Dentate nucleus, 600 Dentatorubral-pallidoluysian atrophy, 612t, 653 Deorsumduction, 386t

Depression, 560

Depth perception, definition of, 345t Depth plane, fixation and, 25 Descending parallel pathways

saccades and, 130f, 135–142, 286–288 voluntary gaze control and, 295–299, 296f

Descending vestibular nucleus (DVN), 32, 33 Deviation. See also Gaze deviation; Strabismus

comitant, 386t, 402 concomitant, 386t, 402 primary, 386t, 407, 409–410

secondary, 386t, 407, 409–410, 411, 414 vertical, 407–409, 408f

dissociated, 355, 415, 498, 518 epilepsy and, 670

wrong-way, 645, 654, 673 Diabetes mellitus

abducens nerve palsy and, 422–423 oculomotor nerve palsy and, 432–433 trochlear nerve palsy and, 425

3,4-Diaminopyridine, in nystagmus, 492, 529t, 531 Diazepam, 525t

divergence insufficiency and, 370 in saccadic hypermetria, 534

Dichoptic viewing devices, 367 Diencephalon, lesions of, 645–648, 646b, 647f Diffuse Lewy-body disease, 643, 651, 670 Dimenhydrinate, 577t

Dimorphic endings, of hair cells, 31 Diplopia, 344. See also Strabismus

A-pattern, 411

Bielschowsky head-tilt test in, 407–409, 408f clinical testing in, 402–409, 408f convergence insufficiency and, 368

cover tests in, 406–407, 406f, 407f crossed, 386t, 404

fixation switch, 415 history in, 402–403

internuclear ophthalmoplegia and, 627 monocular, 403

pathophysiological approach to, 386–387 range of eye movements in, 404 subjective testing of, 404–406, 405f uncrossed, 387t, 404

V-pattern, 411

Dipping, ocular, 674t, 675f

Directional preponderance, of vestibular system, 73 Disconjugate adaptation, 364–366

clinical implications of, 364–366, 365f properties of, 364

Disconjugate nystagmus, 477

Disjunctive movements. See Vergence eye movements Disparity

absolute, 352 examination of, 366 fixation, 349 relative, 352

vergence eye movements and, 12, 344, 346, 366 Dissociated nystagmus, 477, 621

Dissociated vertical deviation, 355, 415, 498, 518

Index 733

Divergence. See also Vergence eye movements nystagmus and, 371

repetitive, 371 synergistic, 430

Divergence excess, 367

Divergence insufficiency, 367, 368, 370 Divergence (Cüppers) procedure, 529t Divergent nystagmus, 371, 511–512, 608

Dix-Hallpike maneuver, 69, 571, 571f–572f, 719–720 Dizziness, 559–578. See also Vertigo

DNA, mitochondrial, disorders of, 446–447, 446t Dodge, R., 108, 188

Dolichoectasia, of basilar artery, 421, 579, 601 Doll’s-head maneuver, 676

Donders’ law, 391 Dopamine receptors, 294

Dorsal cuneus, optic flow and, 208 Dorsal light reflex, 415

Dorsal midbrain syndrome, 371, 634–637, 635b, 635t Dorsal terminal nucleus, 213, 285

Dorsal vermis, 14, 278b

lesions of, 160t, 212–213, 278–279, 606b, 607–608 pharmacological decortication of, 146

saccade generation and, 146–146, 148–149, 278, 278b saccadic adaptation and, 155

smooth pursuit and, 202, 211–212 target velocity in space and, 212 vergence eye movements and, 359

Dorsolateral pontine nucleus lesions of, 211

saccade generation and, 145–146 smooth pursuit and, 191, 211

Dorsolateral prefrontal cortex, 660 descending pathways from, 298

lesions of, 118, 161t, 293–294, 661b, 662–663 saccade generation and, 130f, 139

saccadic adaptation and, 155 vergence eye movements and, 360

voluntary eye movement control and, 293–294, 293b Dorsomedial pulvinar, 143, 289

Double elevator palsy, 637 Double Eye, 387

Double vision. See Diplopia Double-step stimulus, 119, 119f

mediodorsal thalamic nucleus inactivation and, 142 parietal eye field lesions and, 141–142

parietal lobe lesions and, 659

saccades and, 137, 140, 141, 142, 156, 288, 292, 295 Downbeat nystagmus, 202, 255, 478

amyotrophic lateral sclerosis and, 644–645 asymmetric vertical pursuit and, 492 cancer and, 614

cerebellar disease and, 491, 607, 608

clinical features of, 482–485, 482t, 483f, 484b convergence component of, 372 convergence spasm and, 370

divergence component of, 371 divergence nystagmus and, 512 etiology of, 482t

glutamic acid decarboxylase autoantibodies and, 492 in head-hanging position, 484

hypomagnesemia and, 495 hypothetical scheme for, 483f increasing velocity waveform in, 499f in multiple sclerosis, 679

neural integrator in, 492

734 Index

Downbeat nystagmus (Continued) oscillopsia and, 580–581 pathogenesis of, 488–493 periodic, 495

in prone position, 484 smooth pursuit and, 485, 492

suboccipital decompression in, 538 treatment of, 530–531

waveform of, 251 Down’s syndrome, 518

Dragged-fovea diplopia syndrome, 403 Drift, post-saccadic, 112, 116, 148, 414 Drugs, 683–686, 684t–685t

downbeat nystagmus with, 482t eye-head tracking with, 333 gaze-evoked nystagmus with, 254, 500 internuclear ophthalmoplegia with, 622t ocular flutter with, 525t, 526

oculogyric crisis with, 651 opsoclonus with, 525t, 526 ping-pong gaze with, 675 saccades with, 163

slow saccades with, 629t

vergence eye movements and, 368

Duane syndrome, 417, 417t, 419–421, 449t, 450 abduction twitch in, 420, 421f adduction-related upshoot in, 420

anatomy of, 419–420 classification of, 419 clinical features of, 419 etiology of, 420–421

extraocular muscle abnormalities and, 420–421 horizontal recti in, 420

mouse models of, 420 pathophysiology of, 420, 421f thalidomide and, 420

type-I, 420 type-III, 420

Duchenne’s dystrophy, 393, 445 Duction, 386t

Duction test, forced, 404 Duncker illusion, 195 Dynamic overshoots

in normal subjects, 527

post-saccade, 112–113, 113f, 157, 157f in square-wave jerks, 523

Dyskinesia, tardive, 654 Dyslexia, 120–122

Dysmetria, 158. See also Saccadic hypermetria; Saccadic hypometria

pulse, 116

pulse-step mismatch, 116, 148, 154, 161f Dystrophin, 445

Dystrophy, muscular, 445–446

Ear. See also Labyrinth congenital anomalies of, 562t vascular disease of, 562t

EBN (excitatory burst neurons), 125t, 126, 267, 268, 270 Edinger-Wesphal nucleus, 401

Edrophonium (Tensilon), 404 in botulism, 438

in Lambert-Eaton myasthenic syndrome, 439 in myasthenia gravis, 443

Efference, 196 Efference copy, 15

frontal eye field and, 137

infantile nystagmus syndrome and, 516 internal medullary lamina of thalamus and, 142

medial superior temporal visual area and, 206–207 oscillopsia and, 580

parietal eye field lesions and, 142 parietal lobe and, 659 past-pointing and, 410

pontine nuclei and, 211 proprioception and, 396

saccades and, 118, 122–123, 148, 150 smooth pursuit and, 206–207, 216 spatial localization and, 123 thalamus and, 646, 648

Effort of will, 123 intensity of, 410

Egocentric frame of reference, 123

Egocentric localization, disturbance of, 410–411 Elderly persons. See Age Electrocochleography, 566

Electromyography (EMG), 721

in benign paroxysmal positional vertigo, 75, 575 in myasthenia gravis, 443–444

Electro-oculography (EOG), 721, 722 in saccade evaluation, 159

Electro-optical device, in pendular nystagmus, 536 Encephalitis, 437, 629

brainstem, 525–526, 534, 629 Encephalopathy

hepatic, 495t, 674t, 675 hypoxic, 505t

Wernicke’s, 163–164, 485, 599–600, 680t, 681–682, 682f

Endolymph, 26 flow of, 28

Endolymphatic hydrops (Ménière’s syndrome), 562t, 563, 565–566

End-point nystagmus, 254, 500–501, 500b Enophthalmos, trauma and, 436 Enucleation, 411

EOG (electro-oculography), 721, 722 Ephaptic neural transmission, 438

Epicanthic folds, penlight corneal examination and, 404 Epidermoid tumor, 568, 569f

Epilepsy, 562t, 669–670 head turning in, 331–332 nystagmus in, 63, 505, 669 skew deviation in, 583 tornado, 63, 568, 659 vertigo and, 568–569

Episodic vertigo and ataxia, 500, 533, 562t, 576, 612t Epley maneuver, 576, 578

Esodeviation, paralysis of, 358 Esotropia

A-pattern, 415

cerebellar disease and, 608 thalamic, 370, 646 V-pattern, 415

Essential palatal tremor, 600 Ewald, J.R., 21

first law of, 28

second law of, 30, 67, 75

Excitatory burst neurons, 125t, 126, 267, 268, 270 Excitotoxin, omnipause neurons lesions with, 129

Excycloduction, 386t

Exocentric cues, spatial constancy and, 123 Exophthalmos, 447

Exotropia

A-pattern, 415, 635t

in internuclear ophthalmoplegia, 625 pontine, paralytic, 628

V-pattern, 415, 635t

Express saccades, 110f, 110t, 115, 191, 299 adaptation of, 154–155

in progressive supranuclear palsy, 641 in schizophrenia, 672

Extorsion, 388t

Extraocular muscle(s). See also specific muscles actions of, 388t

anatomy of, 8, 387–392, 388f, 388t, 389f atrophy of, 446

botulinum toxin injection of, 393, 536–538, 536f–537f central global layer of, 389, 393, 394–395, 394f, 395f co-contraction of, 433

congenital fibrosis of, 449–450, 449t decay accelerating factor of, 393 disorders of, 393

in autosomal recessive myopathy, 445–446 in congenital myopathy, 446

in Duane syndrome, 420–421, 421f in Duchenne’s dystrophy, 445

in myasthenia gravis, 439–443, 440t in myotonic dystrophy, 445

in oculopharyngeal dystrophy, 445 excitation-contraction of, 393 experimental denervation of, 393 fibers of, 392–396, 394f, 395f genetic disorders of, 449–450, 449t glycogen of, 393

motor unit size in, 392

multiply innervated fibers of, 393–394 muscle spindles of, 396

in muscular dystrophy, 445–446 musculotendinous junctions of, 410 myosin of, 392–393

myotendinous junctions of, 396 non-twitch fibers of, 392, 394

palisade tendon organs of, 392, 396, 400f, 410, 538 peripheral orbital layer of, 389, 393, 394–395, 394f,

395f

phasic contraction of, 243

proprioceptors of, 15, 392, 396, 400f, 402, 410–411, 538

pulley system of, 388f, 389, 391–392 pulling actions of, 288t, 389–392, 390f recruitment of, 394–396, 395f

in saccades, 124 safety factor of, 393

sarcomeric organization of, 393 semicircular canal effects on, 31 singly innervated fibers of, 393 stretch reflex of, 402

surgical procedures for, in nystagmus, 529t, 538 tonic contraction of, 243

transcriptional regulation of, 393 twitch fibers of, 392

Extraocular muscle palsy, 408–409, 408f head tilts with, 411

oscillopsia and, 580 smooth pursuit in, 223

Index 735

Extrapersonal space, internal map of, 411

Eye movements, 3–16. See also specific types of eye movement

adaptive control of, 13–14 bedside examination of, 718–720 during fixation, 5, 6f

functional classes of, 4, 5–6, 5t

head movement and. See Eye-head movements laboratory examination of, 721–723 measurement of, 3–4, 4f, 13, 721–723

neural substrate for. See at Brainstem; Cerebral hemispheres; and specific eye movements and neural structures

optokinetic, 12

orbital mechanics in, 6–8, 7f scientific method for, 15–16 spatial localization and, 14–15 three-dimensional aspects of, 13 visual requirements of, 5

voluntary control of, 14. See also Cerebral hemispheres, voluntary eye movement control and

Eye position central, 386t in head, 15

mechanical forces on, 241–242, 242f null point, 516

primary, 13, 386t, 391 secondary, 386t

in space. See Gaze tertiary, 387t

Eye-closing apraxia, 640

Eye-head movements, 12, 315–335

in congenital ocular motor apraxia, 667, 667f disorders of, 329–335, 330t

examination of, 327, 720

head stabilization and, 315–317, 316f disorders of, 329–331

laboratory evaluation of, 328–329, 329f during locomotion, 315–317, 316f

in ocular motor apraxia, 328, 332, 666–668, 667f in Parkinson’s disease, 650

superior colliculus stimulation and, 133 tracking and. See Eye-head tracking voluntary control of, 317–327

disorders of, 331–335, 333f, 334f

rapid gaze shifts and, 317–324, 318f, 319f, 320f, 322f

smooth tracking and, 325–327, 325f Eye-head neurons, eye-head tracking and, 326 Eye-head saccades, 317–322

adaptation of, 321 cardiac surgery and, 333f

countermanding task effect on, 319

customary ocular motor range in, 319–320, 320f duration of, 321, 322f

dynamic properties of, 318–319, 318f expected target presentation and, 321 eye-only range in, 319–320, 320f head movements during, 319–321 hypometria of, 324

main sequence for, 318, 319f neural substrate for, 322–325

frontal lobe in, 324

mesencephalic reticular formation in, 323 nucleus reticularis gigantocellularis in, 322–323 paramedian pontine reticular formation in, 323

736 Index

Eye-head saccades (Continued)

rostral interstitial nucleus of medial longitudinal fasciculus in, 323

spinal motoneurons in, 322 superior colliculus in, 323–324 vestibular nucleus neurons in, 323

in Parkinson’s disease, 650 self-paced, 321

target distance and, 328–329 unexpected target presentation and, 321 velocity waveform for, 318f, 319 vestibulo-ocular reflex and, 321–322 waveforms for, 318–319, 318f

Eye-head tracking, 12, 325–327 age and, 333

behavioral properties of, 325–326, 325f disorders of, 333–335, 334f

drug effects on, 333 examination of, 327

neural substrate for, 326–327 in Parkinson’s disease, 650

vestibulo-ocular reflex and, 325–326, 325f Eye-only range, gaze shift and, 319–320, 320f Eyelid(s)

abnormalities of

in dorsal midbrain syndrome, 635, 635t in myasthenia gravis, 440

in progressive supranuclear palsy, 640 binocular suture of, 225

examination of, 718

movements of, saccades and, 156–158, 158f retraction of, 156, 429, 635, 640

Eyelid flutter, in epilepsy, 669 Eyelid nystagmus, 372, 521

Facial palsy, abducens nucleus lesions and, 617 Faintness, presyncopal, 559

Falls, in progressive supranuclear palsy, 638 Familial episodic vertigo and ataxia type 2, 500, 533,

562t, 576

Familial Lewy-body disease, 643 Fascia, orbital, 387–389, 388f Fascioscapulohumeral dystrophy, 445 Fastigial nucleus, 14, 36, 275f, 279b

lesions of, 148–149, 160t, 279–280, 533, 606b, 607–608, 608f

pharmacological inactivation of, 332 posterior. See Fastigial oculomotor region saccades and, 130f, 147–149, 149f, 155 smooth pursuit and, 212

vergence eye movements and, 358–359 Fastigial oculomotor region, 279b

lesions of, 607 saccades and, 147

smooth pursuit and, 213

vergence movements and, 358–359 Fatigue

muscle, 440 saccadic, 159 visual, 366

Fatigue nystagmus, 254, 440, 441f, 501 Fernández, C., 21

Ferrier, D., 135–136, 145

Fibromuscular pulleys, for extraocular muscles, 388f, 389 Field-holding reflex, 190

First-order motion stimuli, 193, 204, 221 Fisher syndrome, 436–437

Fistula carotid-cavernous, 435 perilymph, 562t, 563

Fixation, 5, 5t, 6f, 11–12, 189–197, 479. See also Smooth pursuit

abnormalities of, 217, 219–220 age and, 217

alternate, 406

cerebellar disease and, 608 in children, 217

clinical examination of, 217 depth plane and, 25 disengagement of, 137

in elderly, 217 examination of, 719

eye movements during, 5, 6f frontal eye field and, 291

gaze stability during, 189–191, 190f in Huntington’s disease, 652 laboratory evaluation of, 218–219 latent nystagmus and, 224–225 nystagmus and, 220, 253, 478 ocular motoneurons in, 243, 243f parietal lobe neurons in, 191 predictor mechanism in, 217 pulvinar and, 648

slow drifts during, 190

smooth pursuit vs., 191–193, 192f spasm of, 115, 663

target distance and, 25 Fixation disparity, 349 Fixation region, 291 Fixation switch diplopia, 415

Floccular target neurons, 34, 59, 62 Flocculus, 35, 36, 275f, 276–277, 276b

electrophysiology of, 59–60 eye-head tracking and, 327 lesions of, 605b, 607

downbeat nystagmus and, 491–492, 530 gaze holding and, 277, 500

phoria adaptation and, 364 saccadic adaptation and, 155 smooth pursuit and, 212, 277 smooth tracking and, 607 vestibulo-ocular reflex and, 60

neural integrator adaptation and, 251 smooth pursuit and, 202, 212 vergence eye movements and, 358

vestibulo-ocular reflex adaptation and, 59–62, 61f, 202 Flocculus hypothesis, 60

Flourens, P., 21 Flourens law, 28 Flutter

eyelid, 669

ocular. See Ocular flutter Foramen lacerum, tumors of, 422 Forced duction test, 404

Forehead vibration, in nystagmus, 539 Fossa of Rosenmuller, tumors of, 422

Fourier transform, in smooth pursuit evaluation, 219 Fourth nerve palsy. See Trochlear nerve palsy Fovea, 5

center of, visual acuity and, 5 lesions of, 194

saccades and, 109

Foveation periods, in congenital nystagmus, 225, 516–517, 528

Foville’s syndrome, 418 Fracture

orbital, 436 temporal bone, 563

Free will, 14, 15f

Frenzel goggles, 67, 719, 720

in gaze-holding evaluation, 253 in nystagmus examination, 478 in one-and-a-half syndrome, 628

Friedreich’s ataxia, 165, 220, 608, 612t, 614 Frontal eye field, 660. See also Frontal lobe

countermanding task and, 137 descending pathways from, 298 eyeblink and, 156

eye-head saccades and, 324 fixation and, 527

fixation region projection of, 136

lesions of, 131, 137–138, 160t, 221, 290, 299, 661b, 662 microstimulation of, 136

motor map of, 136 neurophysiology of, 136–137

pharmacological inactivation of, 299, 527 saccades and, 130f, 155

smooth pursuit and, 191, 208–209 three-dimensional motion and, 209 vergence eye movements and, 359

voluntary eye movement control and, 289–290, 290b, 296

Frontal lobe. See also Dorsolateral prefrontal cortex; Frontal eye field; Supplementary eye field

eye-head saccades and, 324 lesions of, 660–663, 661b

in Huntington’s disease, 652–653 saccades and, 116, 164, 299 smooth pursuit and, 221

saccade generation and, 130f, 135–140 vergence eye movements and, 359–360

voluntary eye movement control and, 289–292, 290b, 292b

Frontotemporal lobar degeneration, 643, 670 Fusion, definition of, 345t

Fusional maldevelopment nystagmus syndrome, 513, 517b, 518–519

clinical features of, 517b, 518–519 pathogenesis of, 519–520

Fusional vergence, 12, 344, 346, 366

GABA. See Gamma-aminobutyric acid (GABA) Gabapentin

in macrosaccadic oscillations, 534 in nystagmus, 529t, 531, 532

in oculopalatal tremor, 600–601

in superior oblique myokymia, 427 Gain, 21t

pursuit, 199, 201, 215, 219, 223 saccadic, 159–160

vestibulo-ocular reflex. See Vestibulo-ocular reflex (VOR) gain

Galen, 21

Galvanic stimulation, in vestibular disorders, 74 Gamma-aminobutyric acid (GABA), 529

in nucleus prepositus hypoglossi, 247–248 periodic alternating nystagmus and, 495

Index 737

receptor for, 529–530

of vestibular afferents, 31, 529 of vestibular neurons, 35, 36, 37

Ganglionic degeneration, cortical-basal, 643, 651 Gangliosidosis, GM1, 668–669

Gap stimuli

saccades and, 114–115 smooth pursuit and, 211

Gasoline sniffing, 686 Gasserian ganglion, 396

Gaucher’s disease, 163, 629, 666t, 680t, 681

Gaze. See also Gaze holding; and specific eye movements angle of, 5, 6, 317

cardinal (diagnostic) positions of, 386t

paralysis of. See Horizontal gaze palsy; Vertical gaze palsy

rapid shifts of. See Eye-head saccades stability of, 189–191, 191f

during darkness, 190, 190f disorders of, 329–331

during fixation, 189–191, 190f

Gaze control, 262–299. See also at specific neural structures

brainstem in, 262–274. See also Brainstem cerebellum in, 274–280. See also Cerebellum cerebral hemispheres in, 280–295. See also Cerebral

hemispheres, voluntary eye movement control and descending pathways in, 295–299, 296f

superior colliculus in, 298 Gaze deviation

acute hemispheric lesions and, 654–656, 655b downward, 673

in normal infant, 635

thalamic hemorrhage and, 645–646 in epilepsy, 654, 670

forced downward, 673 intermittent, 673

periodic alternating, 674t, 675 in unconscious patient, 673–674 upward, 673

Gaze distractibility, in Wilson’s disease, 683 Gaze holding, 241–257

clinical evaluation of, 253–254 congenital failure of, 517

constant velocity drifts and, 476f, 479

disorders of, 252. See also Gaze-evoked nystagmus; Rebound nystagmus

excitotoxin-produced failure of, 248–250, 248f, 249f instability of, 249

neural network approach to, 249f, 251–253, 252f neural substrate for, 246–253

cerebellum in, 249f, 250–251 interstitial nucleus of Cajal in, 250

nucleus prepositus hypoglossi in, 247–250, 247t optimization of, 479

Gaze palsy. See Horizontal gaze palsy; Vertical gaze palsy Gaze saccades. See Eye-head saccades

Gaze-evoked nystagmus, 8, 161f, 190, 254–256, 498–500, 498b, 499f

centripetal drift in, 253–254 cerebellar disorders and, 254, 607 clinical evaluation of, 253–254

clinical features of, 498–500, 498b, 499f decreasing-velocity waveform of, 476f, 479 dissociated, 625

drug-induced, 254, 500

end-point nystagmus vs., 500–501, 500b

738 Index

Gaze-evoked nystagmus (Continued) epilepsy and, 669

examination of, 719 fatigue-type, 501

in internuclear ophthalmoplegia, 255, 273, 625 in myasthenia gravis, 440, 440t, 441f pathogenesis of, 254–255, 498–500, 499f physiological, 501

slow-phase drift with, 476f, 479 vertical, 255, 273

vestibular disorders and, 254–255 waveform of, 251, 253–254

in Wernicke’s encephalopathy, 681 Gaze-paretic nystagmus, 253, 498

Gegenrucke (square-wave jerks), 164–165, 219, 220, 522b, 523, 523f

Gene therapy, in nystagmus, 533 Gentamicin

in Ménière’s syndrome, 576 toxicity of, 579

Geotropic nystagmus, 70, 573 Gerstmann-Sträussler-Scheinker disease, 671 Giant-cell arteritis, 562t

Gilles de la Tourette’s syndrome, 654 Glioma, pontine, 422

Glissade, 60, 112, 116, 148 Globus pallidus, lesions of, 297 Glutamate, 31, 37, 262, 533

Glutamate NMDA antagonist, NPH-MVN inactivation with, 530

Glutamate transporter, 644

Glutamic acid decarboxylase, autoantibodies to, 492 Glutaric aciduria, 680t

Glycine, 37

Glycopyrrolate, in nystagmus, 532 GM1 gangliosidosis, 668–669 Goggles. See Frenzel goggles Goldberg, J., 21

GQ1b, antibodies to, 437 Gradenigo’s syndrome, 421 Granulomatous angiitis, 425

Graves ophthalmopathy, 447–448, 448f Gravity

otolith organs response to, 22, 23–24 perception of, 24

Grey matter, periaqueductal, 274, 631 Guadeloupe, progressive supranuclear palsy in, 643 Guam, parkinsonism dementia complex of, 643 Guillain, G., 509, 600

Guillain-Barré syndrome, 434t, 436–437

Haemophilis influenza, 437 Hair cells, 26, 26f, 27, 31 Half-angle rule, 49, 390f, 391

Halo-pelvic traction, diplopia after, 421 Harada-Ito procedure, 427

Harding, A., 611

Haw River syndrome, 612t, 653 Head. See also Head trauma

eye position in, 15 inertia of, 317 mass of, 317

perturbation frequency of, 316 stabilization of, 315–317, 316f in strabismus examination, 403

tonic deviation of, 327 tremors of, 330

Head and neck stimulation, in nystagmus, 529t Head heave maneuver, 68, 561–562

Head impulse maneuver, 67–68, 561 canal planes for, 67

Head movements, 12. See also Eye-head movements; Eye-head tracking

in cerebellar disease, 332 congenital disorders of, 331 disorders of, 329–335, 330t examination of, 327–329

during eye-head saccades, 319–321 image stabilization during, 5–6

in nystagmus evaluation, 481 in ocular motor apraxia, 332 in ocular motor palsy, 320, 333 oscillopsia and, 329, 579

in Parkinson’s disease, 332–333 rotational. See Head rotations with slow saccades, 332 translational. See Head translations

vestibulo-ocular response to, 8–10, 8f, 9f, 10f visual acuity and, 579

Head nodding, in spasmus nutans syndrome, 520, 521 Head nystagmus, 327

Head oscillations, in infantile nystagmus syndrome, 516 Head posture, examination of, 718

Head pursuit. See Eye-head tracking Head rotations, 22–23

acceleration-velocity integration and, 30 active vs. passive, 44–45

eccentric, 48–49 frequency of, 23

geometric relationships during, 329, 329f high-velocity, 30

horizontal (yaw), 22, 23, 315

surge, translational vestibulo-ocular reflex and, 49–50 sustained, 9–10, 10f, 30

torsional (roll), 22, 23, 315, 498 vertical (pitch), 22, 23, 315

vertical ocular misalignment with, 23 Head saccades. See Eye-head saccades

Head thrusts, in ocular motor apraxia, 332, 667, 667f Head tilt, 23–24. See also Ocular tilt reaction

central mesencephalic reticular formation inactivation and, 323

examination for, 327

head translation vs., 24, 38, 39, 46–47, 46f, 47f, 78, 560–561

otolith pathways for, 37, 37f strabismus and, 411

in Wallenberg’s syndrome, 80, 604 Head translations, 22–23

depth plane and, 25

head tilt vs., 24, 38, 39, 46–47, 46f, 47f, 78, 560–561 high-velocity, 30

otolith pathways for, 37, 37f synchronization of, 317 target distance and, 25 vertical (bob), 22, 315

Head trauma

oculomotor nerve palsy and, 433 ophthalmoplegia and, 436 trochlear nerve palsy and, 424–425 vertigo and, 562t, 563–564

Head tremor, 330