Eye Movement Disorders-classification_Dr.Kurts

Question 1

Pathology of the EOMs Locations?

Answer 1

1. in a muscle or muscles
2. in the synapse between a nerve ending and the muscle
3. in the orbit

Question 2

Pathology of a nerve that controls EOMs locations?

Answer 2

1. in the brainstem nucleus (midbrain or pons)
2. in the brainstem where the axons traverse the brain, aka “interstial compartment”
3. in the space from the exit of the axons from the brain to the muscle.

Question 3

Pathology of pre-motor structures that control the nerve nuclei that control nerves that control EOMs Locations?

Answer 3

1. PPRF (horizontal)
2. riMLF (vertical)
3. Vestibular nuclei - CN8
4. Medial longitudinal fasciculus (MLF) = internuclear

Question 4

Pathology of structures that control the nuclei and EOMs to maintain fixation (pre-motor) Locations?

Answer 4

1. semicircular canals
2. CN 8
3. Vestibular nuclei
4. Cerebellum (especially the flocculonodular lobes)

Question 5

Pathology of higher order (supranuclear”) structures that control the pre-motor structures that control the nerve nuclei that control nerves that control EOMs Locations?

Answer 5

superior colliculus
frontal eye fields (frontal lobe - saccades)
occipital eye field (pursuits)

Question 6

What is the location of the pathology with patient presenting sign/symptom of diplopia?

Answer 6

orbit, EOM, synapse, nucleus or nerve

Question 7

What is the location of pathology with patient presenting sign/symptom of diplopia sub-type “INO”?

Answer 7

pre-motor structures (riMLF & PPRF, vestibular nuclei)

Question 8

What is the location of pathology with patient presenting sign/symptom of gaze palsy?

Answer 8

supranuclear structures

Question 9

What is the location of pathology with patient presenting sign/symptom of nystagmus?

Answer 9

vestibular system, CN 8

Question 10

what are the associated signs/symptoms with neurological disease presents in the orbit?

Answer 10

space-occupying, CN 5

Question 11

what are the associated signs/symptoms with neurological disease presents in the orbital apex?

Answer 11

space occupying, CN 2

Question 12

what are the associated signs/symptoms with neurological disease presents in the nerve?

Answer 12

aneurysm, other space occupying lesion, inflammation

Question 13

what are the associated signs/symptoms with neurological disease presents in the nerve nucleus and interstitial axons (midbrain)?

Answer 13

contralateral voluntary somatic movement, incoordination

Question 14

what are the associated signs/symptoms with neurological disease presents in the nerve nucleus and interstitial axons (pons)?

Answer 14

contralateral voluntary somatic movement, incoordination, dysmetria (lack of coordination of movement), imbalance, dizziness

Question 15

what are the associated signs/symptoms with neurological disease presents in the pre-motor (brainstem)?

Answer 15

incoordination, dysmetria (movement of the wrong size), imbalance, dizziness.

Question 16

what are the associated signs/symptoms with neurological disease presents in the pre-motor (supranuclear)

Answer 16

Aphasia, psychological, VF defects

Question 17

what are the associated signs/symptoms with neurological disease presents in the vestibular system, CN 8?

Answer 17

contralateral voluntary somatic movement, facial asymmetry, reduced auditory sensitivity.

Question 18

Name a few checklist in the EOM Analysis.

Answer 18

1. symptoms alleiated by reduction in trigger activity
2. any history of difficulty with keys in locks, working doornobs
3. any change in mental status or any other associations
4. prior diagnosis of functional anomaly
5. gaze palsy in any direction

Question 19

What are the four main categories of eye movement disorders?

Answer 19

1. Binocular diplopia
2. Diplopia sub-type “INO” or “internuclear ophthalmoplegia”
3. Gaze palsy
4. Nystagmus