Neuro-Ophthalmology: Case Based Practice

Description

This book provides a practical guide in neuro-ophthalmology. It contains more than 80 carefully selected neuro-ophthalmic cases. It covers visual afferent (Part 1) and efferent disorders (Part 2): the various optic neuropathies, diplopia from ocular and neurologic pathogen, pupil and lid abnormality. Each case presents with neuro-ophthalmology examination format, followed by ancillary test, finial diagnose, treatment and prognosis. A short review or comment highlights the important points of these disorders, up to date progress and literature are addressed in part of them. The novel optical coherence tomography imaging technique is also introduced to interpretation some visual pathway disorders and for follow-up. The massive photographs and neuro-imaging will help the reader for easy following. As a case-based practical manual, this book is a clinical reference for general ophthalmologist, neurologist, senior ophthalmology resident, specialist and fellow, and physician who are interested in neuro-ophthalmology field. Preface Contents Part I: Afferent Disorders 1: Optic Neuritis 1.1 Case 1: Optic Neuritis with Idiopathic Demyelination 1.1.1 Case Presentation 1.1.2 Neuro-Ophthalmologic Examination 1.1.3 Ancillary Test 1.1.4 Formulation 1.1.5 Diagnosis 1.1.6 Differential Diagnosis 1.1.7 Management 1.1.8 Prognosis 1.1.9 Comments 1.2 Case 2: Optic Neuritis with Myelin Oligodendrocyte Glycoprotein Antibody Seropositive 1.2.1 Case Presentation 1.2.2 Neuro-Ophthalmologic Examination 1.2.3 Ancillary Test 1.2.4 Formulation 1.2.5 Diagnosis 1.2.6 Differential Diagnosis 1.2.7 Management 1.2.8 Prognosis 1.2.9 Comments 1.3 Case 3: Optic Neuritis Associated with Multiple Sclerosis 1.3.1 Case Presentation 1.3.2 Neuro-Ophthalmologic Examination 1.3.3 Ancillary Test 1.3.4 Formulation 1.3.5 Management 1.3.6 Prognosis 1.3.7 Diagnosis 1.3.8 Differential Diagnosis 1.3.9 Comments 1.4 Case 4: Pediatric Optic Neuritis 1.4.1 Case Presentation 1.4.2 Neuro-Ophthalmologic Examination 1.4.3 Ancillary Test 1.4.4 Formulation 1.4.5 Diagnosis 1.4.6 Differential Diagnosis 1.4.7 Management 1.4.8 Prognosis 1.4.9 Comments 1.5 Case 5: Acute Disseminated Encephalomyelitis 1.5.1 Case Presentation 1.5.2 Neuro-Ophthalmologic Examination 1.5.3 Ancillary Test 1.5.4 Formulation 1.5.5 Diagnosis 1.5.6 Differential Diagnosis 1.5.7 Management 1.5.8 Prognosis 1.5.9 Comments References Case 1: Optic Neuritis with Idiopathic Demyelination Case 2: Optic Neuritis with Myelin Oligodendrocyte Glycoprotein Antibody Seropositive Case 3: Optic Neuritis Associated with Multiple Sclerosis Case 4: Pediatric Optic Neuritis Case 5: Acute Disseminated Encephalomyelitis 2: Neuromyelitis Optica 2.1 Case 1: Neuromyelitis Optica 2.1.1 Case Presentation 2.1.2 Neuro-Ophthalmologic Examination 2.1.3 Ancillary Test 2.1.4 Formulation 2.1.5 Diagnosis 2.1.6 Differential Diagnosis 2.1.7 Management 2.1.8 Prognosis 2.1.9 Comments 2.2 Case 2: Sjögren’s Syndrome 2.2.1 Case Presentation 2.2.2 Neuro-Ophthalmologic Examination 2.2.3 Ancillary Test 2.2.4 Formulation 2.2.5 Diagnosis 2.2.6 Differential Diagnosis 2.2.7 Management 2.2.8 Prognosis 2.2.9 Comments 2.3 Case 3: Behcet’s Disease 2.3.1 Case Presentation 2.3.2 Neuro-Ophthalmologic Examination 2.3.3 Ancillary Test 2.3.4 Formulation 2.3.5 Diagnosis 2.3.6 Differential Diagnosis 2.3.7 Management 2.3.8 Prognosis 2.3.9 Comments References Case 1: Neuromyelitis Optica Case 2: Sjögren’s Syndrome Case 3: Behcet’s Disease 3: Optic Neuropathy of Inflammation and Infiltration 3.1 Case 1: Granulomatosis Polyangiitis 3.1.1 Case Presentation 3.1.2 Neuro-Ophthalmologic Examination 3.1.3 Ancillary Test 3.1.4 Formulation 3.1.5 Diagnosis 3.1.6 Differential Diagnosis 3.1.7 Management 3.1.8 Prognosis 3.1.9 Comments 3.2 Case 2: Sarcoidosis 3.2.1 Case Presentation 3.2.2 Neuro-Ophthalmologic Examination 3.2.3 Ancillary Test 3.2.4 Formulation 3.2.5 Diagnosis 3.2.6 Differential Diagnosis 3.2.7 Management 3.2.8 Prognosis 3.2.9 Comments 3.3 Case 3: Rosai-Dorfman Disease 3.3.1 Case Presentation 3.3.2 Neuro-ophthalmologic Examination 3.3.3 Ancillary Test 3.3.4 Formulation 3.3.5 Diagnosis 3.3.6 Differential Diagnosis 3.3.7 Management 3.3.8 Prognosis 3.3.9 Comments 3.4 Case 4: Lung Carcinoma 3.4.1 Case Presentation 3.4.2 Neuro-Ophthalmologic Examination 3.4.3 Ancillary Test 3.4.4 Formulation 3.4.5 Diagnosis 3.4.6 Differential Diagnosis 3.4.7 Management 3.4.8 Prognosis 3.4.9 Comments 3.5 Case 5: Breast Carcinoma 3.5.1 Case Presentation 3.5.2 Neuro-Ophthalmologic Examination 3.5.3 Ancillary Test 3.5.4 Formulation 3.5.5 Diagnosis 3.5.6 Differential Diagnosis 3.5.7 Management 3.5.8 Prognosis 3.5.9 Comments 3.6 Case 6: Lymphocytic Leukemia (Acute) 3.6.1 Case Presentation 3.6.2 Neuro-Ophthalmologic Examination 3.6.3 Ancillary Test 3.6.4 Formulation 3.6.5 Diagnosis 3.6.6 Differential Diagnosis 3.6.7 Management 3.6.8 Prognosis 3.6.9 Comments 3.7 Case 7: Lymphocytic Leukemia (Chronic) 3.7.1 Case Presentation 3.7.2 Neuro-ophthalmologic Examination 3.7.3 Ancillary Test 3.7.4 Formulation 3.7.5 Diagnosis 3.7.6 Differential Diagnosis 3.7.7 Management 3.7.8 Prognosis 3.7.9 Comments 3.8 Case 8: Non-Hodgkin Lymphoma 3.8.1 Case Presentation 3.8.2 Neuro-Ophthalmologic Examination 3.8.3 Ancillary Test 3.8.4 Formulation 3.8.5 Diagnosis 3.8.6 Differential Diagnosis 3.8.7 Management 3.8.8 Prognosis 3.8.9 Comments References Case 1: Granulomatosis Polyangiitis Case 2: Sarcoidosis Case 3: Rosai-Dorfman Disease Case 4: Lung Carcinoma Case 5: Breast Carcinoma Case 6: Lymphocytic Leukemia (Acute) Case 7: Lymphocytic Leukemia (Chronic) Case 8: Non-Hodgkin Lymphoma 4: Optic Neuropathy of Infectious 4.1 Case 1: Optic Neuropathy in Nontuberculosis Mycobacteria Infection 4.1.1 Case Presentation 4.1.2 Neuro-Ophthalmologic Examination 4.1.3 Ancillary Test 4.1.4 Formulation 4.1.5 Diagnosis 4.1.6 Differential Diagnosis 4.1.7 Management 4.1.8 Prognosis 4.1.9 Comments 4.2 Case 2: Optic Neuropathy in Fungus Infection 4.2.1 Case Presentation 4.2.2 Neuro-Ophthalmologic Examination 4.2.3 Ancillary Test 4.2.4 Formulation 4.2.5 Diagnosis 4.2.6 Differential Diagnosis 4.2.7 Management 4.2.8 Prognosis 4.2.9 Comments 4.3 Case 3: Optic Neuropathy in Syphilis Infection 4.3.1 Case Presentation 4.3.2 Neuro-Ophthalmologic Examination 4.3.3 Ancillary Test 4.3.4 Formulation 4.3.5 Diagnosis 4.3.6 Differential Diagnosis 4.3.7 Management 4.3.8 Prognosis 4.3.9 Comments References Case 1: Optic Neuropathy in Nontuberculosis Mycobacteria Infection Case 2: Optic Neuropathy in Fungus Infection Case 3: Optic Neuropathy in Syphilis Infection 5: Neuroretinitis 5.1 Case 1: Syphilis Infection 5.1.1 Case Presentation 5.1.2 Neuro-Ophthalmologic Examination 5.1.3 Ancillary Test 5.1.4 Formulation 5.1.5 Diagnosis 5.1.6 Differential Diagnosis 5.1.7 Management 5.1.8 Prognosis 5.1.9 Comments 5.2 Case 2: Cat Scratch Disease 5.2.1 Case Presentation 5.2.2 Neuro-Ophthalmologic Examination 5.2.3 Ancillary Test 5.2.4 Formulation 5.2.5 Diagnosis 5.2.6 Differential Diagnosis 5.2.7 Management 5.2.8 Prognosis 5.2.9 Comments References Case 1: Syphilis Infection Case 2: Cat Scratch Disease 6: Nonarteritic Anterior Ischemic Optic Neuropathy 6.1 Case 1: Drug Induced 6.1.1 Case Presentation 6.1.2 Neuro-Ophthalmologic Examination 6.1.3 Ancillary Test 6.1.4 Formulation 6.1.5 Diagnosis 6.1.6 Differential Diagnosis 6.1.7 Management 6.1.8 Prognosis 6.1.9 Comments 6.2 Case 2: Nonarteritic Anterior Ischemic Optic Neuropathy (High Altitude) 6.2.1 Case Presentation 6.2.2 Neuro-Ophthalmologic Examination 6.2.3 Ancillary Test 6.2.4 Formulation 6.2.5 Diagnosis 6.2.6 Differential Diagnosis 6.2.7 Management 6.2.8 Prognosis 6.2.9 Comments 6.3 Case 3: Nonarteritic Anterior Ischemic Optic Neuropathy (After Surgery) 6.3.1 Case Presentation 6.3.2 Neuro-Ophthalmologic Examination 6.3.3 Ancillary Test 6.3.4 Formulation 6.3.5 Diagnosis 6.3.6 Differential Diagnosis 6.3.7 Management 6.3.8 Prognosis 6.3.9 Comments 6.4 Case 4: Nonarteritic Anterior Ischemic Optic Neuropathy (Drusen) 6.4.1 Case Presentation 6.4.2 Neuro-Ophthalmologic Examination 6.4.3 Ancillary Test 6.4.4 Formulation 6.4.5 Diagnosis 6.4.6 Differential Diagnosis 6.4.7 Management 6.4.8 Prognosis 6.4.9 Comments 6.5 Case 5: Nonarteritic Anterior Ischemic Optic Neuropathy (Iatrogenic) 6.5.1 Case Presentation 6.5.2 Neuro-Ophthalmologic Examination 6.5.3 Ancillary Test 6.5.4 Formulation 6.5.5 Diagnosis 6.5.6 Differential Diagnosis 6.5.7 Management 6.5.8 Prognosis 6.5.9 Comments References Case 1: Drug Induced Case 2: Nonarteritic Anterior Ischemic Optic Neuropathy (High Altitude) Case 3: Nonarteritic Anterior Ischemic Optic Neuropathy (After Surgery) Case 4: Nonarteritic Anterior Ischemic Optic Neuropathy (Drusen) Case 5: Nonarteritic Anterior Ischemic Optic Neuropathy (Iatrogenic) 7: Arteritic Anterior Ischemic Optic Neuropathy 7.1 Case 1: Giant Cell Arteritis 7.1.1 Case Presentation 7.1.2 Neuro-Ophthalmologic Examination 7.1.3 Ancillary Test 7.1.4 Formulation 7.1.5 Diagnosis 7.1.6 Differential Diagnosis 7.1.7 Management 7.1.8 Prognosis 7.1.9 Comments 7.2 Case 2: Giant Cell Arteritis (Bilateral) 7.2.1 Case Presentation 7.2.2 Neuro-Ophthalmologic Examination 7.2.3 Ancillary Test 7.2.4 Formulation 7.2.5 Diagnosis 7.2.6 Differential Diagnosis 7.2.7 Management 7.2.8 Prognosis 7.2.9 Comments 7.3 Case 3: Giant Cell Arteritis (Without Visual Loss) 7.3.1 Case Presentation 7.3.2 Neuro-Ophthalmologic Examination 7.3.3 Ancillary Test 7.3.4 Formulation 7.3.5 Diagnosis 7.3.6 Differential Diagnosis 7.3.7 Management 7.3.8 Prognosis 7.3.9 Comments 7.4 Case 4: Behcet’s Disease 7.4.1 Case Presentation 7.4.2 Neuro-Ophthalmologic Examination 7.4.3 Ancillary Test 7.4.4 Formulation 7.4.5 Diagnosis 7.4.6 Differential Diagnosis 7.4.7 Management 7.4.8 Prognosis 7.4.9 Comments References Case 1: Giant Cell Arteritis Case 2: Giant Cell Arteritis (Bilateral) Case 3: Giant Cell Arteritis (Without Visual Loss) Case 4: Behcet’s Disease 8: Leber Hereditary Optic Neuropathy 8.1 Case 1: Leber Hereditary Optic Neuropathy (Mutation 11778) 8.1.1 Case Presentation 8.1.2 Neuro-Ophthalmologic Examination 8.1.3 Ancillary Test 8.1.4 Formulation 8.1.5 Diagnosis 8.1.6 Differential Diagnosis 8.1.7 Management 8.1.8 Prognosis 8.1.9 Comments 8.2 Case 2: Leber Hereditary Optic Neuropathy (11778 Mutation, Pediatric) 8.2.1 Case Presentation 8.2.2 Neuro-Ophthalmologic Examination 8.2.3 Ancillary Test 8.2.4 Formulation 8.2.5 Diagnosis 8.2.6 Differential Diagnosis 8.2.7 Management 8.2.8 Prognosis 8.2.9 Comments 8.3 Case 3: Leber Hereditary Optic Neuropathy (11778 Mutation, Elder) 8.3.1 Case Presentation 8.3.2 Neuro-Ophthalmologic Examination 8.3.3 Ancillary Test 8.3.4 Formulation 8.3.5 Diagnosis 8.3.6 Differential Diagnosis 8.3.7 Management 8.3.8 Prognosis 8.3.9 Comments 8.4 Case 4: Leber Hereditary Optic Neuropathy (11778 Mutation, Sequential) 8.4.1 Case Presentation 8.4.2 Neuro-Ophthalmologic Examination 8.4.3 Ancillary Test 8.4.4 Formulation 8.4.5 Diagnosis 8.4.6 Differential Diagnosis 8.4.7 Management 8.4.8 Prognosis 8.4.9 Comments 8.5 Case 5: Leber Hereditary Optic Neuropathy (11778 Mutation, with MRI Enhanced) 8.5.1 Case Presentation 8.5.2 Neuro-Ophthalmologic Examination 8.5.3 Ancillary Test 8.5.4 Formulation 8.5.5 Diagnosis 8.5.6 Differential Diagnosis 8.5.7 Management 8.5.8 Prognosis 8.5.9 Comments 8.6 Case 6: Leber Hereditary Optic Neuropathy (Mutation 13513) 8.6.1 Case Presentation 8.6.2 Neuro-Ophthalmologic Examination 8.6.3 Ancillary Test 8.6.4 Formulation 8.6.5 Diagnosis 8.6.6 Differential Diagnosis 8.6.7 Management 8.6.8 Prognosis 8.6.9 Comments 8.7 Case 7: Leber Hereditary Optic Neuropathy (Mutation 14484) 8.7.1 Case Presentation 8.7.2 Neuro-Ophthalmologic Examination 8.7.3 Ancillary Test 8.7.4 Formulation 8.7.5 Diagnosis 8.7.6 Differential Diagnosis 8.7.7 Management 8.7.8 Prognosis 8.7.9 Comments 8.8 Case 8: Leber Hereditary Optic Neuropathy (Mutation 3460) 8.8.1 Case Presentation 8.8.2 Neuro-Ophthalmologic Examination 8.8.3 Ancillary Test 8.8.4 Formulation 8.8.5 Diagnosis 8.8.6 Differential Diagnosis 8.8.7 Management 8.8.8 Prognosis 8.8.9 Comments 8.9 Case 9: Leber Hereditary Optic Neuropathy (Mutation 4174 + 12811) 8.9.1 Case Presentation 8.9.2 Neuro-Ophthalmologic Examination 8.9.3 Ancillary Test 8.9.4 Formulation 8.9.5 Diagnosis 8.9.6 Differential Diagnosis 8.9.7 Management 8.9.8 Prognosis 8.9.9 Comments References Case 1: Leber Hereditary Optic Neuropathy (Mutation 11778) Case 2: Leber Hereditary Optic Neuropathy (11778 mutation, pediatric) Case 3: Leber Hereditary Optic Neuropathy (11778 mutation, elder) Case 4: Leber Hereditary Optic Neuropathy (11778 mutation, sequential) Case 5: Leber Hereditary Optic Neuropathy (11778 Mutation, with MRI Enhanced) Case 6: Leber Hereditary Optic Neuropathy (Mutation 13513) Case 7: Leber Hereditary Optic Neuropathy (Mutation 14484) Case 8: Leber Hereditary Optic Neuropathy (Mutation 3460) Case 9: Leber Hereditary Optic Neuropathy (Mutation 4174+12811) 9: Other Hereditary Optic Neuropathy 9.1 Case 1: Dominant Optic Atrophy (OPA1) 9.1.1 Case Presentation 9.1.2 Neuro-Ophthalmologic Examination 9.1.3 Ancillary Test 9.1.4 Formulation 9.1.5 Diagnosis 9.1.6 Differential Diagnosis 9.1.7 Management 9.1.8 Prognosis 9.1.9 Comments 9.2 Case 2: Dominant Optic Atrophy (OPA1 + mtDNA11696 Mutation) 9.2.1 Case Presentation 9.2.2 Neuro-Ophthalmologic Examination 9.2.3 Ancillary Test 9.2.4 Formulation 9.2.5 Diagnosis 9.2.6 Differential Diagnosis 9.2.7 Management 9.2.8 Prognosis 9.2.9 Comments 9.3 Case 3: Hereditary Optic Neuropathy (POLG Mutation) 9.3.1 Case Presentation 9.3.2 Neuro-Ophthalmologic Examination 9.3.3 Ancillary Test 9.3.4 Formulation 9.3.5 Diagnosis 9.3.6 Differential Diagnosis 9.3.7 Management 9.3.8 Prognosis 9.3.9 Comments 9.4 Case 4: Hereditary Optic Neuropathy (NDUSF2 Mutation) 9.4.1 Case Presentation 9.4.2 Neuro-Ophthalmologic Examination 9.4.3 Ancillary Test 9.4.4 Formulation 9.4.5 Diagnosis 9.4.6 Differential Diagnosis 9.4.7 Management 9.4.8 Prognosis 9.4.9 Comments 9.5 Case 5: Wolfram Syndrome (Type I) 9.5.1 Case Presentation 9.5.2 Neuro-Ophthalmologic Examination 9.5.3 Ancillary Test 9.5.4 Formulation 9.5.5 Diagnosis 9.5.6 Differential Diagnosis 9.5.7 Management 9.5.8 Prognosis 9.5.9 Comments 9.6 Case 6: Wolfram Syndrome (Type 2) 9.6.1 Case Presentation 9.6.2 Neuro-Ophthalmologic Examination 9.6.3 Ancillary Test 9.6.4 Formulation 9.6.5 Diagnosis 9.6.6 Differential Diagnosis 9.6.7 Management 9.6.8 Prognosis 9.6.9 Comments 9.7 Case 7: Spinocerebellar Ataxia Type28 (SCA28) 9.7.1 Case Presentation 9.7.2 Neuro-Ophthalmologic Examination 9.7.3 Ancillary Test 9.7.4 Formulation 9.7.5 Diagnosis 9.7.6 Differential Diagnosis 9.7.7 Management 9.7.8 Prognosis 9.7.9 Comments References Case 1: Dominant Optic Atrophy (OPA1) Case 2: Dominant Optic Atrophy (OPA1+mtDNA11696 mutation) Case 3: Hereditary Optic Neuropathy (POLG Mutation) Case 4 Case 5: Wolfram Syndrome (Type I) Case 6: Wolfram Syndrome (Type 2) Case 7: Spinocerebellar Ataxia Type28 (SCA28) 10: Toxic Optic Neuropathy 10.1 Case 1: Ethambutol Toxic Neuropathy 10.1.1 Case Presentation 10.1.2 Neuro-Ophthalmologic Examination 10.1.3 Ancillary Test 10.1.4 Formulation 10.1.5 Diagnosis 10.1.6 Differential Diagnosis 10.1.7 Management 10.1.8 Prognosis 10.1.9 Comments 10.2 Case 2: Ethambutol Toxic Neuropathy in OPA1 Mutation 10.2.1 Case Presentation 10.2.2 Neuro-Ophthalmologic Examination 10.2.3 Ancillary Test 10.2.4 Formulation 10.2.5 Diagnosis 10.2.6 Differential Diagnosis 10.2.7 Management 10.2.8 Prognosis 10.2.9 Comments 10.3 Case 3: Toxic Optic Neuropathy (Methanol) 10.3.1 Case Presentation 10.3.2 Neuro-Ophthalmologic Examination 10.3.3 Ancillary Test 10.3.4 Formulation 10.3.5 Diagnosis 10.3.6 Differential Diagnosis 10.3.7 Management 10.3.8 Prognosis 10.3.9 Comments 10.4 Case 4: Toxic Optic Neuropathy (Penicillamine) 10.4.1 Case Presentation 10.4.2 Neuro-Ophthalmologic Examination 10.4.3 Ancillary Test 10.4.4 Formulation 10.4.5 Diagnosis 10.4.6 Differential Diagnosis 10.4.7 Management 10.4.8 Prognosis 10.4.9 Comments 10.5 Case 5: Toxic Optic Neuropathy (Thiamine-Deficient) 10.5.1 Case Presentation 10.5.2 Neuro-Ophthalmologic Examination 10.5.3 Ancillary Test 10.5.4 Formulation 10.5.5 Diagnosis 10.5.6 Differential Diagnosis 10.5.7 Management 10.5.8 Prognosis 10.5.9 Comments 10.6 Case 6: Toxic Optic Neuropathy (Anthelmintic) 10.6.1 Case Presentation 10.6.2 Neuro-Ophthalmologic Examination 10.6.3 Ancillary Test 10.6.4 Formulation 10.6.5 Diagnosis 10.6.6 Differential Diagnosis 10.6.7 Management 10.6.8 Prognosis 10.6.9 Comments References Case 1: Ethambutol Toxic Neuropathy Case 2: Ethambutol Toxic Neuropathy in OPA1 Mutation Case 3: Toxic Optic Neuropathy (Methanol) Case 4: Toxic Optic Neuropathy (Penicillamine) Case 5: Toxic Optic Neuropathy (Thiamine-Deficient) Case 6: Toxic Optic Neuropathy (Anthelmintic) 11: Papilledema 11.1 Case 1: Idiopathy Intracranial Hypertension 11.1.1 Case Presentation 11.1.2 Neuro-Ophthalmologic Examination 11.1.3 Ancillary Test 11.1.4 Formulation 11.1.5 Diagnosis 11.1.6 Differential Diagnosis 11.1.7 Management 11.1.8 Prognosis 11.1.9 Comments 11.2 Case 2: Pseudotumor Cerebri Syndrome (Secondary to Polycystic Ovarian Syndrome) 11.2.1 Case Presentation 11.2.2 Neuro-Ophthalmologic Examination 11.2.3 Ancillary Test 11.2.4 Formulation 11.2.5 Diagnosis 11.2.6 Differential Diagnosis 11.2.7 Management 11.2.8 Prognosis 11.2.9 Comments 11.3 Case 3: Pseudotumor Cerebri Syndromes (Secondary to Venous Stenosis) 11.3.1 Case Presentation 11.3.2 Neuro-Ophthalmologic Examination 11.3.3 Ancillary Test 11.3.4 Formulation 11.3.5 Diagnosis 11.3.6 Differential Diagnosis 11.3.7 Management 11.3.8 Prognosis 11.3.9 Comments 11.4 Case 4: Papilledema (Secondary to Subarachnoid Hemorrhage) 11.4.1 Case Presentation 11.4.2 Neuro-Ophthalmologic Examination 11.4.3 Ancillary Test 11.4.4 Formulation 11.4.5 Diagnosis 11.4.6 Differential Diagnosis 11.4.7 Management 11.4.8 Prognosis 11.4.9 Comments 11.5 Case 5: Papilledema (Secondary to Glioma) 11.5.1 Case Presentation 11.5.2 Neuro-Ophthalmologic Examination 11.5.3 Ancillary Test 11.5.4 Formulation 11.5.5 Diagnosis 11.5.6 Differential Diagnosis 11.5.7 Management 11.5.8 Prognosis 11.5.9 Comments 11.6 Case 6: Papilledema (Secondary to Meningeal Carcinomatosis) 11.6.1 Case Presentation 11.6.2 Neuro-Ophthalmologic Examination 11.6.3 Ancillary Test 11.6.4 Formulation 11.6.5 Diagnosis 11.6.6 Differential Diagnosis 11.6.7 Management 11.6.8 Prognosis 11.6.9 Comments 11.7 Case 7: Papilledema (Secondary to Iatrogenic) 11.7.1 Case Presentation 11.7.2 Neuro-Ophthalmologic Examination 11.7.3 Ancillary Test 11.7.4 Formulation 11.7.5 Diagnosis 11.7.6 Differential Diagnosis 11.7.7 Management 11.7.8 Prognosis 11.7.9 Comments 11.8 Case 8: Papilledema (Secondary to Hydrocephalus) 11.8.1 Case Presentation 11.8.2 Neuro-Ophthalmologic Examination 11.8.3 Ancillary Test 11.8.4 Formulation 11.8.5 Diagnosis 11.8.6 Differential Diagnosis 11.8.7 Management 11.8.8 Prognosis 11.8.9 Comments 11.9 Case 9: Papilledema (Secondary to Arachnoid Cyst) 11.9.1 Case Presentation 11.9.2 Neuro-Ophthalmologic Examination 11.9.3 Ancillary Test 11.9.4 Formulation 11.9.5 Diagnosis 11.9.6 Differential Diagnosis 11.9.7 Management 11.9.8 Prognosis 11.9.9 Comments 11.10 Case 10: Papilledema (Secondary to Arteriovenous Fistula) 11.10.1 Case Presentation 11.10.2 Neuro-Ophthalmologic Examination 11.10.3 Ancillary Test 11.10.4 Formulation 11.10.5 Diagnosis 11.10.6 Differential Diagnosis 11.10.7 Management 11.10.8 Prognosis 11.10.9 Comments 11.11 Case 11: Papilledema (Secondary to Arteriovenous Malformation) 11.11.1 Case Presentation 11.11.2 Neuro-Ophthalmologic Examination 11.11.3 Ancillary Test 11.11.4 Formulation 11.11.5 Diagnosis 11.11.6 Differential Diagnosis 11.11.7 Management 11.11.8 Prognosis 11.11.9 Comments References Case 1: Idiopathy Intracranial Hypertension Case 2: Pseudotumor Cerebri Syndrome (Secondary to Polycystic Ovarian Syndrome) Case 3: Pseudotumor Cerebri Syndromes (Secondary to Venous Stenosis) Case 4: Papilledema (Secondary to Subarachnoid Hemorrhage) Case 5: Papilledema (Secondary to Glioma) Case 6: Papilledema (Secondary to Meningeal Carcinomatosis) Case 7: Papilledema (Secondary to Iatrogenic) Case 9: Papilledema (Secondary to Arachnoid Cyst) Case 10: Papilledema (Secondary to Arteriovenous Fistula) 12: Compressive Optic Neuropathy 12.1 Case 1: Aneurysm 12.1.1 Case Presentation 12.1.2 Neuro-Ophthalmologic Examination 12.1.3 Ancillary Test 12.1.4 Formulation 12.1.5 Diagnosis 12.1.6 Differential Diagnosis 12.1.7 Management 12.1.8 Prognosis 12.1.9 Comments 12.2 Case 2: Optic Nerve Sheath Meningioma 12.2.1 Case Presentation 12.2.2 Neuro-Ophthalmologic Examination 12.2.3 Ancillary Test 12.2.4 Formulation 12.2.5 Diagnosis 12.2.6 Differential Diagnosis 12.2.7 Management 12.2.8 Prognosis 12.2.9 Comments 12.3 Case 3: Meningioma 12.3.1 Case Presentation 12.3.2 Neuro-Ophthalmologic Examination 12.3.3 Ancillary Test 12.3.4 Formulation 12.3.5 Diagnosis 12.3.6 Differential Diagnosis 12.3.7 Management 12.3.8 Prognosis 12.3.9 Comments 12.4 Case 4: Chiasm Glioma 12.4.1 Case Presentation 12.4.2 Neuro-Ophthalmologic Examination 12.4.3 Ancillary Test 12.4.4 Formulation 12.4.5 Diagnosis 12.4.6 Differential Diagnosis 12.4.7 Management 12.4.8 Prognosis 12.4.9 Comments 12.5 Case 5: Myofibroma 12.5.1 Case Presentation 12.5.2 Neuro-Ophthalmologic Examination 12.5.3 Ancillary Test 12.5.4 Formulation 12.5.5 Diagnosis 12.5.6 Differential Diagnosis 12.5.7 Management 12.5.8 Prognosis 12.5.9 Comments 12.6 Case 6: Fibrous Dysplasia 12.6.1 Case Presentation 12.6.2 Neuro-Ophthalmologic Examination 12.6.3 Ancillary Test 12.6.4 Formulation 12.6.5 Diagnosis 12.6.6 Differential Diagnosis 12.6.7 Management 12.6.8 Prognosis 12.6.9 Comments References Case 1: Aneurysm Case 2: Optic Nerve Sheath Meningioma Case 3: Meningioma Case 4: Chiasm Glioma Case 5: Myofibroma Case 6: Fibrous Dysplasia 13: Retinopathy and Vision Loss 13.1 Case 1: Sialidosis 13.1.1 Case Presentation 13.1.2 Neuro-Ophthalmologic Examination 13.1.3 Ancillary Test 13.1.4 Formulation 13.1.5 Diagnosis 13.1.6 Differential Diagnosis 13.1.7 Management 13.1.8 Prognosis 13.1.9 Comments 13.2 Case 2: Spinocerebellar Ataxia 13.2.1 Case Presentation 13.2.2 Neuro-Ophthalmologic Examination 13.2.3 Ancillary Test 13.2.4 Formulation 13.2.5 Diagnosis 13.2.6 Differential Diagnosis 13.2.7 Management 13.2.8 Prognosis 13.2.9 Comments 13.3 Case 3: Neuronal Intranuclear Inclusion Disease 13.3.1 Case Presentation 13.3.2 Neuro-Ophthalmologic Examination 13.3.3 Ancillary Test 13.3.4 Formulation 13.3.5 Diagnosis 13.3.6 Differential Diagnosis 13.3.7 Management 13.3.8 Prognosis 13.3.9 Comments 13.4 Case 4: Susac Syndrome 13.4.1 Case Present 13.4.2 Neuro-Ophthalmologic Examination 13.4.3 Ancillary Test 13.4.4 Formulation 13.4.5 Diagnosis 13.4.6 Differential Diagnosis 13.4.7 Management 13.4.8 Prognosis 13.4.9 Comments 13.5 Case 5: Lymphoma 13.5.1 Case Presentation 13.5.2 Neuro-Ophthalmologic Examination 13.5.3 Ancillary Test 13.5.4 Formulation 13.5.5 Diagnosis 13.5.6 Differential Diagnosis 13.5.7 Management 13.5.8 Prognosis 13.5.9 Comments 13.6 Case 6: Cancer-Associated Retinopathy 13.6.1 Case Presentation 13.6.2 Neuro-Ophthalmologic Examination 13.6.3 Ancillary Test 13.6.4 Formulation 13.6.5 Diagnosis 13.6.6 Differential Diagnosis 13.6.7 Management 13.6.8 Prognosis 13.6.9 Comments 13.7 Case 7: Iatrogenic Ophthalmic Artery Occlusion 13.7.1 Case Presentation 13.7.2 Neuro-Ophthalmologic Examination 13.7.3 Ancillary Test 13.7.4 Formulation 13.7.5 Diagnosis 13.7.6 Differential Diagnosis 13.7.7 Management 13.7.8 Prognosis 13.7.9 Comments References Case 1: Sialidosis Case 2: Spinocerebellar Ataxia Case 3: Neuronal Intranuclear Inclusion Disease Case 4: Susac Syndrome Case 5: Lymphoma Case 6: Cancer-Associated Retinopathy Case 7: Iatrogenic Ophthalmic Artery Occlusion 14: Cortical Blindness 14.1 Case 1: NMDAR Encephalitis 14.1.1 Case Presentation 14.1.2 Neuro-Ophthalmologic Examination 14.1.3 Ancillary Test 14.1.4 Formulation 14.1.5 Diagnosis 14.1.6 Differential Diagnosis 14.1.7 Management 14.1.8 Prognosis 14.1.9 Comments 14.2 Case 2. Sporadic Creutzfeldt–Jakob Disease 14.2.1 Case Presentation 14.2.2 Neuro-ophthalmologic Examination 14.2.3 Ancillary Test 14.2.4 Formulation 14.2.5 Diagnosis 14.2.6 Differential Diagnosis 14.2.7 Management 14.2.8 Prognosis 14.2.9 Comments 14.3 Case 3: Stroke 14.3.1 Case Presentation 14.3.2 Neuro-Ophthalmologic Examination 14.3.3 Ancillary Test 14.3.4 Formulation 14.3.5 Diagnosis 14.3.6 Differential Diagnosis 14.3.7 Management 14.3.8 Prognosis 14.3.9 Comments 14.4 Case 4: X-Linked Adrenoleukodystrophy 14.4.1 Case Presentation 14.4.2 Neuro-Ophthalmologic Examination 14.4.3 Ancillary Test 14.4.4 Formulation 14.4.5 Diagnosis 14.4.6 Differential Diagnosis 14.4.7 Management 14.4.8 Prognosis 14.4.9 Comments References Case 1: NMDAR Encephalitis Case 2: Sporadic Creutzfeldt-Jakob Disease Case 3: Stroke Case 4: X-Linked Adrenoleukodystrophy Part II: Efferent Disorders 15: Extraocular Muscle Disorders 15.1 Case 1: Thyroid Eye Disease (Ptosis) 15.1.1 Case Presentation 15.1.2 Neuro-Ophthalmologic Examination 15.1.3 Ancillary Test 15.1.4 Formulation 15.1.5 Diagnosis 15.1.6 Differential Diagnosis 15.1.7 Management 15.1.8 Prognosis 15.1.9 Comments 15.2 Case 2: Thyroid Eye Disease (Diplopia) 15.2.1 Case Presentation 15.2.2 Neuro-Ophthalmologic Examination 15.2.3 Ancillary Test 15.2.4 Formulation 15.2.5 Diagnosis 15.2.6 Differential Diagnosis 15.2.7 Management 15.2.8 Prognosis 15.2.9 Comments 15.3 Case 3: Thyroid Eye Disease (Diplopia and Optic Neuropathy) 15.3.1 Case Presentation 15.3.2 Neuro-Ophthalmologic Examination 15.3.3 Ancillary Test 15.3.4 Formulation 15.3.5 Diagnosis 15.3.6 Differential Diagnosis 15.3.7 Management 15.3.8 Prognosis 15.3.9 Comments 15.4 Case 4: Chronic Progressive External Ophthalmoplegia 15.4.1 Case Presentation 15.4.2 Neuro-Ophthalmologic Examination 15.4.3 Ancillary Test 15.4.4 Formulation 15.4.5 Diagnosis 15.4.6 Differential Diagnosis 15.4.7 Management 15.4.8 Prognosis 15.4.9 Comments References Case 1: Thyroid Eye Disease (Ptosis) Case 3: Thyroid Eye Disease (Diplopia and Optic Neuropathy) Case 4: Chronic Progressive External Ophthalmoplegia 16: Ocular Myasthenia Gravis 16.1 Case 1: Ocular Myasthenia Gravis (Mimic Oculomotor Nerve Palsy) 16.1.1 Case Presentation 16.1.2 Neuro-ophthalmologic Examination 16.1.3 Ancillary Test 16.1.4 Formulation 16.1.5 Diagnosis 16.1.6 Differential Diagnosis 16.1.7 Management 16.1.8 Prognosis 16.1.9 Comments 16.2 Case 2: Ocular Myasthenia Gravis (Mimic Orbital Apex Syndrome) 16.2.1 Case Presentation 16.2.2 Neuro-ophthalmologic Examination 16.2.3 Ancillary Test 16.2.4 Formulation 16.2.5 Diagnosis 16.2.6 Differential Diagnosis 16.2.7 Management 16.2.8 Prognosis 16.2.9 Comments 16.3 Case 3: Ocular Myasthenia Gravis (Mimic Bilateral Internuclear Ophthalmoplegia) 16.3.1 Case Presentation 16.3.2 Neuro-ophthalmologic Examination 16.3.3 Ancillary Test 16.3.4 Formulation 16.3.5 Diagnosis 16.3.6 Differential Diagnosis 16.3.7 Management 16.3.8 Prognosis 16.3.9 Comments References Case 1: Ocular Myasthenia Gravis (Mimic Oculomotor Nerve Palsy) Case 2: Ocular Myasthenia Gravis (Mimic Orbital Apex Syndrome) Case 3: Ocular Myasthenia Gravis (Mimic Bilateral Internuclear Ophthalmoplegia) 17: Oculomotor Nerve Palsy 17.1 Case 1: Oculomotor Nerve Palsy Due to Cavernous Fistula 17.1.1 Case Presentation 17.1.2 Neuro-ophthalmologic Examination 17.1.3 Ancillary Test 17.1.4 Formulation 17.1.5 Diagnosis 17.1.6 Differential Diagnosis 17.1.7 Management 17.1.8 Prognosis 17.1.9 Comments 17.2 Case 2: Schwannoma 17.2.1 Case Presentation 17.2.2 Neuro-ophthalmologic Examination 17.2.3 Ancillary Test 17.2.4 Formulation 17.2.5 Diagnosis 17.2.6 Differential Diagnosis 17.2.7 Management 17.2.8 Prognosis 17.2.9 Comments 17.3 Case 3: Neurofibromatosis 2 17.3.1 Case Presentation 17.3.2 Neuro-ophthalmologic Examination 17.3.3 Ancillary Test 17.3.4 Formulation 17.3.5 Diagnosis 17.3.6 Differential Diagnosis 17.3.7 Management 17.3.8 Prognosis 17.3.9 Comments 17.4 Case 4: Meningioma 17.4.1 Case Presentation 17.4.2 Neuro-ophthalmologic Examination 17.4.3 Ancillary Test 17.4.4 Formulation 17.4.5 Diagnosis 17.4.6 Differential Diagnosis 17.4.7 Management 17.4.8 Prognosis 17.4.9 Comments 17.5 Case 5: Inflammatory 17.5.1 Case Presentation 17.5.2 Neuro-ophthalmologic Examination 17.5.3 Ancillary Test 17.5.4 Formulation 17.5.5 Diagnosis 17.5.6 Differential Diagnosis 17.5.7 Management 17.5.8 Prognosis 17.5.9 Comments 17.6 Case 6: Syphilis Infectious 17.6.1 Case Presentation 17.6.2 Neuro-ophthalmologic Examination 17.6.3 Ancillary Test 17.6.4 Formulation 17.6.5 Diagnosis 17.6.6 Differential Diagnosis 17.6.7 Management 17.6.8 Prognosis 17.6.9 Comments 17.7 Case 7: Iatrogenic 17.7.1 Case Presentation 17.7.2 Neuro-ophthalmologic Examination 17.7.3 Ancillary Test 17.7.4 Formulation 17.7.5 Diagnosis 17.7.6 Differential Diagnosis 17.7.7 Management 17.7.8 Prognosis 17.7.9 Comments 17.8 Case 8: Recurrent Painful Ophthalmoplegia Neuropathy 17.8.1 Case Presentation 17.8.2 Neuro-ophthalmologic Examination 17.8.3 Ancillary Test 17.8.4 Formulation 17.8.5 Diagnosis 17.8.6 Differential Diagnosis 17.8.7 Management 17.8.8 Prognosis 17.8.9 Comments 17.9 Case 9: Recurrent Painful Ophthalmoplegia Neuropathy and Schwannoma 17.9.1 Case Presentation 17.9.2 Neuro-ophthalmologic Examination 17.9.3 Ancillary Test 17.9.4 Formulation 17.9.5 Diagnosis 17.9.6 Differential Diagnosis 17.9.7 Management 17.9.8 Prognosis 17.9.9 Comments 17.10 Case 10: Weber Syndrome 17.10.1 Case Presentation 17.10.2 Neuro-ophthalmologic Examination 17.10.3 Ancillary Test 17.10.4 Formulation 17.10.5 Diagnosis 17.10.6 Differential Diagnosis 17.10.7 Management 17.10.8 Prognosis 17.10.9 Comments 17.11 Case 11: Claude Syndrome 17.11.1 Case Presentation 17.11.2 Neuro-ophthalmologic Examination 17.11.3 Ancillary Test 17.11.4 Formulation 17.11.5 Diagnosis 17.11.6 Differential Diagnosis 17.11.7 Management 17.11.8 Prognosis 17.11.9 Comments 17.12 Case 12: Nucleus Lesion 17.12.1 Case Presentation 17.12.2 Neuro-ophthalmologic Examination 17.12.3 Ancillary Test 17.12.4 Formulation 17.12.5 Diagnosis 17.12.6 Differential Diagnosis 17.12.7 Management 17.12.8 Prognosis 17.12.9 Comments 17.13 Case 13: Oculomotor Nerve Paresis with Cyclic Spasms 17.13.1 Case Presentation 17.13.2 Neuro-ophthalmologic Examination 17.13.3 Ancillary Test 17.13.4 Formulation 17.13.5 Diagnosis 17.13.6 Differential Diagnosis 17.13.7 Management 17.13.8 Prognosis 17.13.9 Comments 17.14 Case 14: Ocular Neuromyotonia 17.14.1 Case Presentation 17.14.2 Neuro-ophthalmologic Examination 17.14.3 Ancillary Test 17.14.4 Formulation 17.14.5 Diagnosis 17.14.6 Differential Diagnosis 17.14.7 Management 17.14.8 Prognosis 17.14.9 Comments References Case 1: Oculomotor Nerve Palsy Due to Cavernous Fistula Case 2: Schwannoma Case 3: Neurofibromatosis 2 Case 4: Meningioma Case 5: Inflammatory Case 6: Syphilis Infectious Case 7: Iatrogenic Case 8: Recurrent Painful Ophthalmoplegia Neuropathy Case 9: Recurrent Painful Ophthalmoplegia Neuropathy and Schwannoma Case 10: Weber Syndrome Case 11: Claude Syndrome Case 12: Nucleus Lesion Case 13: Oculomotor Nerve Paresis with Cyclic Spasms Case 14: Ocular Neuromyotonia 18: Trochlear Nerve Palsy 18.1 Case 1: Nucleus Lesion 18.1.1 Case Presentation 18.1.2 Neuro-ophthalmologic Examination 18.1.3 Ancillary Test 18.1.4 Formulation 18.1.5 Diagnosis 18.1.6 Differential Diagnosis 18.1.7 Management 18.1.8 Prognosis 18.1.9 Comments 18.2 Case 2: Superior Oblique Myokymia 18.2.1 Case Presentation 18.2.2 Neuro-ophthalmologic Examination 18.2.3 Ancillary Test 18.2.4 Formulation 18.2.5 Diagnosis 18.2.6 Differential Diagnosis 18.2.7 Management 18.2.8 Prognosis 18.2.9 Comments References Case 1: Nucleus Lesion Case 2: Superior Oblique Myokymia 19: Abducens Nerve Palsy 19.1 Case 1: Lymphoma 19.1.1 Case Presentation 19.1.2 Neuro-ophthalmologic Examination 19.1.3 Ancillary Test 19.1.4 Formulation 19.1.5 Diagnosis 19.1.6 Differential Diagnosis 19.1.7 Management 19.1.8 Prognosis 19.1.9 Comments 19.2 Case 2: Carotid Cavernous Fistula 19.2.1 Case Presentation 19.2.2 Neuro-ophthalmologic Examination 19.2.3 Ancillary Test 19.2.4 Formulation 19.2.5 Diagnosis 19.2.6 Differential Diagnosis 19.2.7 Management 19.2.8 Prognosis 19.2.9 Comments 19.3 Case 3: Meningioma 19.3.1 Case Presentation 19.3.2 Neuro-ophthalmologic Examination 19.3.3 Ancillary Test 19.3.4 Formulation 19.3.5 Diagnosis 19.3.6 Differential Diagnosis 19.3.7 Management 19.3.8 Prognosis 19.3.9 Comments 19.4 Case 4: Duane Syndrome 19.4.1 Case Presentation 19.4.2 Neuro-ophthalmologic Examination 19.4.3 Ancillary Test 19.4.4 Formulation 19.4.5 Diagnosis 19.4.6 Differential Diagnosis 19.4.7 Management 19.4.8 Prognosis 19.4.9 Comments 19.5 Case 5: Brain Stem Encephalitis 19.5.1 Case Presentation 19.5.2 Neuro-ophthalmologic Examination 19.5.3 Ancillary Test 19.5.4 Formulation 19.5.5 Diagnosis 19.5.6 Differential Diagnosis 19.5.7 Management 19.5.8 Prognosis 19.5.9 Comments 19.6 Case 6: Ocular Neuromyotonia 19.6.1 Case Presentation 19.6.2 Neuro-ophthalmologic Examination 19.6.3 Ancillary Test 19.6.4 Formulation 19.6.5 Diagnosis 19.6.6 Differential Diagnosis 19.6.7 Management 19.6.8 Prognosis 19.6.9 Comments References Case 1: Lymphoma Case 2: Carotid Cavernous Fistula Case 3: Meningioma Case 4: Duane Syndrome Case 5: Brain Stem Encephalitis Case 6: Ocular Neuromyotonia 20: Multiple Cranial Nerve Palsy 20.1 Case 1: Meningioma 20.1.1 Case Presentation 20.1.2 Neuro-ophthalmologic Examination 20.1.3 Ancillary Test 20.1.4 Formulation 20.1.5 Diagnosis 20.1.6 Differential Diagnosis 20.1.7 Management 20.1.8 Prognosis 20.1.9 Comments 20.2 Case 2: Lymphoma 20.2.1 Case Presentation 20.2.2 Neuro-ophthalmologic Examination 20.2.3 Ancillary Test 20.2.4 Formulation 20.2.5 Diagnosis 20.2.6 Differential Diagnosis 20.2.7 Management 20.2.8 Prognosis 20.2.9 Comments 20.3 Case 3: Glioma 20.3.1 Case Presentation 20.3.2 Neuro-ophthalmologic Examination 20.3.3 Ancillary Test 20.3.4 Formulation 20.3.5 Diagnosis 20.3.6 Differential Diagnosis 20.3.7 Management 20.3.8 Prognosis 20.3.9 Comments References Case 1: Meningioma Case 2: Lymphoma Case 3: Glioma 21: Nystagmus 21.1 Case 1: Chiari Malformation (Downbeat Nystagmus) 21.1.1 Case Presentation 21.1.2 Neuro-ophthalmologic Examination 21.1.3 Ancillary Test 21.1.4 Formulation 21.1.5 Diagnosis 21.1.6 Differential Diagnosis 21.1.7 Management 21.1.8 Prognosis 21.1.9 Comments 21.2 Case 2: Midbrain Infarction (Seesaw Nystagmus) 21.2.1 Case Presentation 21.2.2 Neuro-ophthalmologic Examination 21.2.3 Ancillary Test 21.2.4 Formulation 21.2.5 Diagnosis 21.2.6 Differential Diagnosis 21.2.7 Management 21.2.8 Prognosis 21.2.9 Comments 21.3 Case 3: Brainstem Hemangioma (Oculopalatal Myoclonus) 21.3.1 Case Presentation 21.3.2 Neuro-ophthalmologic Examination 21.3.3 Ancillary Test 21.3.4 Formulation 21.3.5 Diagnosis 21.3.6 Differential Diagnosis 21.3.7 Management 21.3.8 Prognosis 21.3.9 Comments 21.4 Case 4: Lymphoma (Convergence Retraction Nystagmus) 21.4.1 Case Presentation 21.4.2 Neuro-ophthalmologic Examination 21.4.3 Ancillary Test 21.4.4 Formulation 21.4.5 Diagnosis 21.4.6 Differential Diagnosis 21.4.7 Management 21.4.8 Prognosis 21.4.9 Comments 21.5 Case 5: Demyelination (Internuclear Ophthalmoplegia) 21.5.1 Case Presentation 21.5.2 Neuro-ophthalmologic Examination 21.5.3 Ancillary Test 21.5.4 Formulation 21.5.5 Diagnosis 21.5.6 Differential Diagnosis 21.5.7 Management 21.5.8 Prognosis 21.5.9 Comments 21.6 Case 6: Medulla Infarction (Upbeat Nystagmus) 21.6.1 Case Presentation 21.6.2 Neuro-ophthalmologic Examination 21.6.3 Ancillary Test 21.6.4 Formulation 21.6.5 Diagnosis 21.6.6 Differential Diagnosis 21.6.7 Management 21.6.8 Prognosis 21.6.9 Comments References Case 1: Chiari Malformation (Downbeat Nystagmus) Case 2. Midbrain Infarction (Seesaw Nystagmus) Case 3. Brainstem Hemangioma (Oculopalatal Myoclonus) Case 4. Lymphoma (Convergence Retraction Nystagmus) Case 5. Demyelination (Internuclear Ophthalmoplegia) Case 6. Medulla Infarction (Upbeat Nystagmus)