Nystagmus series – Part VII
(seesaw & hemi-seesaw nystagmus)
“Maddox rod, double prism Maddox, red glass Maddox, Maddox cross, and Maddox wing”
British ophthalmologist Ernest Edmund Maddox (1863–1933)
(first report)
#MedTwitter #neurotwitter #EndNeurophobia #tweetorials
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(seesaw & hemi-seesaw nystagmus)
“Maddox rod, double prism Maddox, red glass Maddox, Maddox cross, and Maddox wing”
British ophthalmologist Ernest Edmund Maddox (1863–1933)
(first report)
#MedTwitter #neurotwitter #EndNeurophobia #tweetorials
1/
Definition
“one half-cycle of elevation&intorsion of one eye
and
synchronous depression&extorsion of the other eye.
Next half-cycle,
vertical&torsional components are reversed”
- waveform: pendular (seesaw) & jerk (hemi-seesaw)
- hemi-seesaw: only one half-cycle
2/
“one half-cycle of elevation&intorsion of one eye
and
synchronous depression&extorsion of the other eye.
Next half-cycle,
vertical&torsional components are reversed”
- waveform: pendular (seesaw) & jerk (hemi-seesaw)
- hemi-seesaw: only one half-cycle
2/
Pathophysiology
Jerk (hemi-seesaw)
- lesion in the interstitial nucleus of Cajal
Pendular (seesaw)
- parasellar (midbrain compression & visual field defects)
- calibration lesion
3/
Jerk (hemi-seesaw)
- lesion in the interstitial nucleus of Cajal
Pendular (seesaw)
- parasellar (midbrain compression & visual field defects)
- calibration lesion
3/
Fixation
Fixation in central vestibular nystagmus
“poorly suppressed by fixation of a visual target”
- abnormal smooth-pursuit system
4/
Fixation in central vestibular nystagmus
“poorly suppressed by fixation of a visual target”
- abnormal smooth-pursuit system
4/
Associated symptoms
Hemi-seesaw nystagmus
- contralateral ocular tilt reaction
- central otolithic imbalance
Seesaw nystagmus
- visual field defect
5/
Hemi-seesaw nystagmus
- contralateral ocular tilt reaction
- central otolithic imbalance
Seesaw nystagmus
- visual field defect
5/
Considerations
Reversed congenital form
- elevation & extorsion
- dissociated vertical deviation
6/
Reversed congenital form
- elevation & extorsion
- dissociated vertical deviation
6/
Seesaw nystagmus – features
i) 🔄 elevation&intorsion w/ depression&extorsion
ii) no suppress by visual fixation
7/
i) 🔄 elevation&intorsion w/ depression&extorsion
ii) no suppress by visual fixation
7/
Seesaw nystagmus
i) 🔄 elevation&intorsion w/ depression&extorsion
ii) no suppress by visual fixation
youtu.be via: Moran CORE
8/
i) 🔄 elevation&intorsion w/ depression&extorsion
ii) no suppress by visual fixation
youtu.be via: Moran CORE
8/
Seesaw nystagmus
i) 🔄 elevation&intorsion w/ depression&extorsion
ii) no suppress by visual fixation
youtu.be via: Moran CORE
9/
i) 🔄 elevation&intorsion w/ depression&extorsion
ii) no suppress by visual fixation
youtu.be via: Moran CORE
9/
Seesaw nystagmus
i) 🔄 elevation&intorsion w/ depression&extorsion
ii) no suppress by visual fixation
youtu.be via: Frederico Moura
10/
i) 🔄 elevation&intorsion w/ depression&extorsion
ii) no suppress by visual fixation
youtu.be via: Frederico Moura
10/
Seesaw nystagmus
i) 🔄 elevation&intorsion w/ depression&extorsion
ii) no suppress by visual fixation
youtu.be via: Raed Behbehani
11/
i) 🔄 elevation&intorsion w/ depression&extorsion
ii) no suppress by visual fixation
youtu.be via: Raed Behbehani
11/
Seesaw nystagmus
i) 🔄 elevation&intorsion w/ depression&extorsion
ii) no suppress by visual fixation
youtu.be via: Lisa Koch
12/
i) 🔄 elevation&intorsion w/ depression&extorsion
ii) no suppress by visual fixation
youtu.be via: Lisa Koch
12/
Seesaw nystagmus
i) 🔄 elevation&intorsion w/ depression&extorsion
ii) no suppress by visual fixation
youtu.be via: Audiology-Vestibular Science Academy
13/
i) 🔄 elevation&intorsion w/ depression&extorsion
ii) no suppress by visual fixation
youtu.be via: Audiology-Vestibular Science Academy
13/
Seesaw nystagmus
i) 🔄 elevation&intorsion w/ depression&extorsion
ii) no suppress by visual fixation
youtube.com via: Dr Pawan Prasher
14/
i) 🔄 elevation&intorsion w/ depression&extorsion
ii) no suppress by visual fixation
youtube.com via: Dr Pawan Prasher
14/
Seesaw nystagmus
i) 🔄 elevation&intorsion w/ depression&extorsion
ii) no suppress by visual fixation
youtu.be via: Neuroftalmologia em Foco
15/
i) 🔄 elevation&intorsion w/ depression&extorsion
ii) no suppress by visual fixation
youtu.be via: Neuroftalmologia em Foco
15/
Seesaw nystagmus
i) 🔄 elevation&intorsion w/ depression&extorsion
ii) no suppress by visual fixation
youtu.be via: Raed Behbehani
16/
i) 🔄 elevation&intorsion w/ depression&extorsion
ii) no suppress by visual fixation
youtu.be via: Raed Behbehani
16/
Seesaw nystagmus
i) 🔄 elevation&intorsion w/ depression&extorsion
ii) no suppress by visual fixation
youtu.be via: Dr Gamal Sobhy
17/
i) 🔄 elevation&intorsion w/ depression&extorsion
ii) no suppress by visual fixation
youtu.be via: Dr Gamal Sobhy
17/
Hemi-seesaw nystagmus – features
i) elevation&intorsion w/ depression&extorsion
ii) only one half-cycle
iii) no suppress by visual fixation
18/
i) elevation&intorsion w/ depression&extorsion
ii) only one half-cycle
iii) no suppress by visual fixation
18/
Nystagmus general description
"Nystagmus – Moving eyes!!!"
23/
"Nystagmus – Moving eyes!!!"
23/
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