1. how does vertical gaze center work
    "orignates in frontal eye fields or in superior colliculus, requires b/l cortical input, projections travel to rostral interstitial nucleus of the MLF located behind red nucleus in midbrain, fibers travel to nuclei of CN 3 and 4 (upgaze is in lateral portion of riMLF), and downgaze is in media portion of riMLF)"
  2. what nucleus is responsible for torsional movements
    interstitial nucleus of cajal
  3. what disease has prolonged photostress recovery test and what disease has normal?
    "macular has prolonged, optic nerve has normal"
  4. what color deficiency does acquired macular disease have
    blue/yellow in early stages
  5. what color cones are in the fovea
  6. what VEP pattern do you see in toxic or compressive optic neuropathies
    reduction of amplitude more pornounced than prolongation of latency (unlike demylienation where latency is prolonged)
  7. what is cogans dictum
    "retrochiasmal disorder causes homonymous hemianopia -> assymetric OKN indicates parietal lobe lesion, symmetric OKN indicates occipital lobe lesion"
  8. what do you see with downward moving OKN drum in dorsal midbrain syndrome
    conergence retraction nystagmus
  9. what is skew deviation
    "vertical misalignment due to imbalance of prenuclear iputs -> vertical tropia where hypodeviated eye is ipsilateral to lesion -> due to brain stem infract, MS, increaesd ICP -> transient"
  10. what does wipples' disease do to eye
    oclomasticatory myorhythmia (vertical eye movements and facial activity similar to myoclonus)
  11. what os olivopontocerebellar atrophy
    "eye movements progresively slow in all directions until complete external ophtalmoplegia -> 2/2 cerebellar and pontine atrophy -> also unseady gait, slurrd speech, dementia, optic atrophy, retinal degeneration"
  12. "how does kernicterus, wernick'es encelaopathy, maple syrup disease affect eyes"
    progressive loss of eye movements
  13. what is convergence-retraction nystagmus
    due to periaquductal gray matter or dorsal midbrain lesion -> co-contraction of lateral recti produces convergence movement on attempted upgaze
  14. what causes downbeat nystagmus
    "cervicomedullary junction lesion (arnold chiari malformation, tumor, syrinx), spinocerebellar degeneration, intoxication, lithium, paraneoplastic cerebellar degerration"
  15. what causes gaze-evoked nystagmus
    "extra-axial mass compressing brain stem (acousti neuroma, cerebellar hemisphere tumor), intoxication"
  16. what causes seesaw nystagmus
    "suprasellar lesion, cva, trauma, congenital"
  17. what direction is peripheral vestibular disease
    "fast phase toward good side, slow phase toward lesion"
  18. what is opsoclonus
    "rapid, chaotic eye movements in all directions, persists in sleep"
  19. what os ocular motor apraxia
    "saccadic palsy with impairment of volutnary eye movements with preservation of reflex movements, acquired form called Balint's syndrome -> b/l cerebral disease (ASSOCIATED WITH GAUCHER'S, SPINOCEREBELLAR DEGENERATION, mr, WILSONS) -> HEAD THRUSTING, ABNORMAL okn, NORMAL PERSUITS"
  20. what is oculopharyngeal dystorphy
    french candian disease with dysphagia followed by ptosis -> CPEO -> 2/2 vacular myopathy
  21. what chromsome is myoti dystrophy and what makes it worse
    "chrom 19; worse with cold, excitement, fatigue"
  22. what is superior oblique myokymia
    "episodic reptitive firing of SO causes intermittent oscillopsia, shimmering vision, and vertical/torsional diplplia -> idiopathic -> tx with carbamazepine or propanolol"
  23. what are causes of retrobulblar optic neuropathy (rare)
    "anemia and hypotension, medicationuse"
  24. what is pseudo-foster-kennedy syndrome
    AION is most frequent cause of unilateral disc edema and contralateral optic atrophy
  25. what causes pie in the sky visual field defect
    "gliioima, vascular lesion of meyer's loop near temporal lobe"
  26. what is gerstmann's syndrome
    "lesion of dominant parietal lobe (inferior homonymous hemianopia, acalculia, agraphia, finger agnosia, left-right confusion)"
  27. what is foster-kennedy syndrome
    "frontal lobe mass causing anosmia, ipsilateral optic atrophy (from tumor compression) and contralateral ON edema (from elevated ICP)"
  28. what is posterior fossa tumors
    most cause severe papilledema because they encroach on cerebral aqueduct and 4th eventricle with rapid rise in ICP
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