Teaching Video NeuroImages: Functional saccadic oculomotor disturbances. (17th January 2017)

• Record Type: Journal Article
• Authors: Feil, Katharina; Schöberl, Florian; Klemm, Mona; Strupp, Michael
• Is Part Of: Neurology. Volume 88:Number 3(2017)
• Page Start: e30
• Page End: e31
• Publication Date: 2017-01-17
• Subjects: Neurology -- Periodicals; Neurology -- Periodicals; Neurologie -- Périodiques; 616.8
• DOI: 10.1212/WNL.0000000000003513
• Languages: English
• ISSNs: 0028-3878

Abstract

Abstract : A 37-year-old woman presented with persistent spinning vertigo, diplopia, and blurred vision of acute onset 6 months ago. Neuro-ophthalmologic examination revealed oculomotor disturbances (video atNeurology.org ). These eye movements were absent when the patient was not being examined, i.e., when reading or sitting in the waiting hall. Based on these findings and confirmed by video-oculography (figure), the diagnosis of functional oculomotor disturbances could be made. The prevalence of functional oculomotor disturbances is largely unknown, with convergence spasm and functional nystagmus being most common. 1 Video-oculographic documentation allows objective quantification of these high-amplitude eye movements in the presence of well-preserved intersaccadic intervals and dependence of attention in contrast to central oculomotor disturbances. 2 Further, macro square-wave jerks are mostly asymptomatic, paired, small, saccadic intrusions taking the eye off target at an amplitude of 5°–15° and returning after an intersaccadic interval of 70–150 ms. 2 In opsoclonus, symptomatic with blurred vision and oscillopsia, saccadic oscillations occur unpredictably in all directions (horizontal, vertical, and diagonal) without an intersaccadic interval. 2