Term
| What limbs may experience ataxia with lateropulsion? |
|
Definition
| Ataxia of one arm and one leg on the same side as the lateropulsion |
|
|
Term
| Location of lesion causing Wallenberg Syndrome |
|
Definition
| Dorsolateral medullary lesion |
|
|
Term
| Ocular manifestation of Wallenberg Syndrome |
|
Definition
Ipsilesional skew deviation
lateropulsion of fixations & saccades |
|
|
Term
| What syndrome may accompany Wallenberg's syndrome? |
|
Definition
|
|
Term
| How many numbness present itself in Wallenberg syndrome |
|
Definition
ipsilesional numbness of face
contralesional numbness of one arm and leg |
|
|
Term
| Which direction do the eyes move when lids close in lateropulsion |
|
Definition
| They move ipsilesional (so left medullary lesion will cause eyes t move to the left) |
|
|
Term
| How do horizontal saccades manifest in Wallenberg Syndrome |
|
Definition
Hypermetric towards lesions
Hypometric away from lesion |
|
|
Term
| Most common cause of lateral medullary syndrome |
|
Definition
| Vascular occlusion/disection |
|
|
Term
| Occlusion of which 2 arteries most commonly cause lateral medullary syndrome |
|
Definition
Vertebral artery
Posterior inferior cerebellar artery |
|
|
Term
| Which 2 structures in the medulla can affect EOMs and the soft palate and thus be involved in oculopalatal tremor |
|
Definition
Inferior Olivary nucleus in medulla
Red nucleus |
|
|
Term
| Etiology of Oculopalatal Tremor (3) |
|
Definition
Infarct
Hemorrhage
Demyelination (rare) |
|
|
Term
| #1 Treatment for Oculopalatal Tremor (may only affect the APN, not the palate) |
|
Definition
|
|
Term
| 2 Types of nystagmus caused by Paramedian Medullary Lesion |
|
Definition
Upbeat
Horizontal (gaze-evoked) |
|
|
Term
| When the PONS has a one-sided lesion _______________horizontal gaze is impaired but ________________________horizontal gaze is intact INBOTH EYES |
|
Definition
Ipsilateral impaired
Contralesional intact |
|
|
Term
| Which 3 pathways (eye movements) are interrupted by Abducens Nuclear Lesions |
|
Definition
Vergence
Horizontal Saccades
Horizontal VOR & Pursuits |
|
|
Term
| If pt has a horizontal gaze palsy (6th nerve) that prevents them from looking to the left, what side is the lesion? |
|
Definition
|
|
Term
| 4 Differential Diagnoses of Horizontal Gaze Palsy |
|
Definition
Duane Syndrome
Mobius Syndrome
Wernicke's Encephalopathy
Intracranial Mass |
|
|
Term
T or F
Vertical and Vergence eye movements are spared in Abducens Nuclear Lesions |
|
Definition
|
|
Term
| 6 Causes of INO in addition to MS And stroke |
|
Definition
Arnold Chiari
Hydrocephalus
Head trauma
Encephalitis
Drug Intoxication
Nutritional |
|
|
Term
| What may cause a complete lack of ADDUCTION in both eyes, except during convergence |
|
Definition
| Bilateral INO, aka Bilateral lesion of MLF |
|
|
Term
| 2 main causes of INO are stroke and MS, which is more likely to be bilateral and which unilateral |
|
Definition
MS=Bilateral
Stroke=Unilateral |
|
|
Term
| Term for syndrome where abduction only works on one eye and adduction does not work on either, except on convergence |
|
Definition
|
|
Term
| Bilateral INO plus ____________ can cause One and a Half Syndrome |
|
Definition
| Bilateral INO plus unilateral 6th nerve palsy |
|
|
Term
| 2 Causes of One and a Half Syndrome |
|
Definition
1. Bilateral INO + Unilateral 6thnerve palsy
2. MLF and adjacent Abducens nucleus lesion |
|
|
Term
Most common cause of 1 1/2 syndrome in young patients
….in old patients? |
|
Definition
MS in young
Stroke in old
SAME AS INO |
|
|
Term
| 5 most common causes for 1 1/2 syndrome |
|
Definition
MS
Stroke
Tumour
Hemorrhage
Trauma |
|
|
Term
Unilateral PPRF lesions sometimes affect which of the following eye movements
Pursuits
Saccades
VOR |
|
Definition
| Can cause ipsilesiona horizontal saccadic palsy and leave the others intact |
|
|
Term
| Which horizontal eye movements are affected by bilateral PPRF lesions |
|
Definition
| ALL conjugate eye movements |
|
|
Term
| A left PPRF lesion will affect saccades in which direction |
|
Definition
| will cause loss of saccades to the left side |
|
|
Term
| Lesion of which location in the pons will affect vergence and horizontal gaze |
|
Definition
| Lesion in Nucleus Reticularis Tegmenti Pontis |
|
|
Term
| Where do commands for upward and downwards saccades start |
|
Definition
|
|
Term
| Acute downward saccadic palsy is also called ________________________ |
|
Definition
|
|
Term
| How may MLF lesions affect vertical eye movements |
|
Definition
Slowing of downward saccades
Contralesional Torsional Nystagmus
Static Deviations |
|
|
Term
| Basilar Syndrome-Can't Look ______________- |
|
Definition
|
|
Term
| How do MLF lesions affect Vertical VOR, gaze holding and pursuits? |
|
Definition
|
|
Term
| 2 ways that vertical One and A Half Syndrome can manifest |
|
Definition
Upgaze palsy in both eyes, downgaze palsy in ipsilateral eye
Downgaze palsy in both eyes and upgaze palsy in ipsilateral eye |
|
|
Term
| 2 other names for Dorsal Midbrain syndrome |
|
Definition
|
|
Term
| Which direction of eye movements is mostly affected by Dorsal Midbrain Syndrome |
|
Definition
|
|
Term
Restrictied upward eye movements
Downward eye movement preference
Fixation instability
Light-near pupil dissociation
Vestibular system induced head tilt
these all describe which syndrome |
|
Definition
|
|
Term
| Posterior Commisure Lesions cause which syndrome |
|
Definition
|
|
Term
| What is Collier's lid retraction sign and in what syndrome might you see it |
|
Definition
Colliers-dissociation of vertical eye and lid movements
Seen in Dorsal Midbrain Syndrome |
|
|
Term
| In Dorsal Midbrain Syndrome, what sort of eyemovements may be evoked by attempted upward saccades |
|
Definition
| Convergence-Retraction Nystagmus |
|
|
Term
| Which structure is the primary vertical eye movement center for the saccadic step and neural integrator |
|
Definition
| Interstitial Nucleus of Cajal |
|
|
Term
| Skew deviation due to an INC lesion may resemble and CN ____ palsy |
|
Definition
|
|
Term
T or F
INC lesions affect VOR and pursuits |
|
Definition
|
|
Term
| With a lesion of the INC expect _________ tropia, ___________ nystagmus and ___________pitch of the head |
|
Definition
Vertical tropia
Upbeat nystagmus
Backwards pitch of the head |
|
|
Term
| INC is found in which part of the brainstem |
|
Definition
|
|
Term
| How do bilateral INC lesions affect speed of saccades |
|
Definition
|
|
Term
| Location for loss of downward saccades |
|
Definition
|
|
Term
| Most common cause for vertical gaze palsy in infants |
|
Definition
| Congenital aqueduct stenosis which leads to hydrocephalus and compresses posterior commissure |
|
|
Term
| Most common cause for vertical gaze palsy in ages 10-20 |
|
Definition
| Pineal gland tumour --> compression of posterior commissure |
|
|
Term
| Most common cause for vertical gaze palsy in ages 21-30 |
|
Definition
| Head trauma that leads to subdural hematoma |
|
|
Term
| Most common cause for vertical gaze palsy in ages 31-40 |
|
Definition
| Vascular malformation (hemorrhage) |
|
|
Term
| Most common cause for vertical gaze palsy in ages 41-50 |
|
Definition
|
|
Term
| Most common cause for vertical gaze palsy in ages 51-60 |
|
Definition
| Basilar Artery Stroke or infarction |
|
|
Term
| How can the midbrain affect abduction even though the LR nucleus is in the pons |
|
Definition
| If a lesion disrupts communication between the MR and LR in version movements |
|
|
Term
| 3 DDx of slow saccades due to a lesion in the midbrain |
|
Definition
PSP
Whipple's
Amyotrophic lateral sclerosis |
|
|
Term
| Do lesions in the midbrain tend to affect vertical or horizontal saccades first |
|
Definition
|
|
Term
| 4 DDx of slow saccades due to a lesion in the pons |
|
Definition
Spinocerebellar ataxias
PPRF lesion
INO
Paraneoplastic syndrome |
|
|
Term
| 3 diseases that manifest in the basal ganglia and cause slow saccades |
|
Definition
Parkinsons
Huntingtons
Creutzfeld-Jakob |
|
|
Term
| Which is spared in PSP, OKN or VOR |
|
Definition
| VOR generally spared, not OKN |
|
|
Term
| Which disease has a hummingbird sign in imaging |
|
Definition
|
|
Term
| Name a rare infectious cause of APN and oculopalatal tremor |
|
Definition
|
|
Term
These are signs of which disease discussed in class
Joint pain
Chronic digestive problems
swollen lymph nodes
impaired mentation
myoclons
keratitis/uveitis/vitreous hemorrhage
Vertical eye movement dysfunction |
|
Definition
|
|
Term
| Vertical gaze palsy in Whipple's disease mimics what other neurological condition discussed in class |
|
Definition
| Progressive Supernuclear Palsy |
|
|
Term
Treatment of MS
IV prednisolone reduces development of MS for only the first ___ years |
|
Definition
|
|
Term
| 4 most common causes of Wernicke Encephalopathy |
|
Definition
Chronic alcoholism
Malnutrition
chronic renal failure
Hyperalimentation (over-eating) |
|
|
Term
| Wernicke Encephalopathy is a deficiency of which vitamin |
|
Definition
|
|
Term
| Classic triad associated with Wernicke Encephalopathy |
|
Definition
Ophthalmoplegia
Oculomotor Ataxia
Global confusion state (-Wong) |
|
|
Term
| Problems with Eye movements in Wernicke's usually starts with impaired input to which nuclei |
|
Definition
|
|
Term
| Eye movements in Alzheimer's Dementia |
|
Definition
Inability to suppress reflexive saccades (frontal)
Inability to shift visual attention (parietal)
Increased latency of visually guided saccades (Parietal) |
|
|
Term
| Overdose of which substance can mimic Creutzfeld Jakob Disease |
|
Definition
| Lithium (remember the 7 UP) |
|
|
Term
| Top 3' Eye movements in CJD |
|
Definition
Slow saccades
PAN
Centripetal nystagmus |
|
|
Term
| Eye movements in AIDS due to frontal lobe involvement |
|
Definition
Increased saccadic latency
Fixation instability
Errors on antisaccades
Ocular Motor Apraxia |
|
|
