Eye Movements in the Critical Care Setting

Description

Details common eye movement issues found in critical care units for everyday practice Provides a thorough grounding of the anatomy and physiology of the ocular motor system Written by experts in the field Preface Contents 1: Primer on Examination and Interpretation of Eye Movements in Critically Ill Patients Defining and Differentiating the Disorders of Stable Gaze Nystagmus Jerk Nystagmus Pendular Nystagmus Saccadic Intrusions Square Waves Saccadic Oscillations Examination and Interpretation of Common Disorders of Gaze-Holding Nystagmus Gaze-Evoked Nystagmus Downbeat Nystagmus Upbeat Nystagmus Torsional Nystagmus Pseudo-Pendular Nystagmus Seesaw Nystagmus Impaired VOR Matrix Saccades Pursuits Ten Rules of Eye Movement and Vestibular Examination Rule 1: Be Sure to Have the Preliminaries Rule 2: Keep the Distance Rule 3: Color of the Visual Target Should Be Bright Rule 4: Check the Alignment of the Eyes Rule 5: Mindful of the Patient’s Age and Home Medication Profile Rule 6: Stabilize the Patient’s Head Rule 7: Pay Attention to the Eyelids Rule 8: Use Ophthalmoscope If Needed Rule 9: Look at the Bridge of the Nose Rule 10: Head Impulses Should Be Brief But Fast 2: Approach to Nystagmus Primary Position Jerk Nystagmus Downbeat Nystagmus Mechanism Causes and Management Upbeat Nystagmus Mechanism Causes and Management Horizontal Nystagmus Periodic Alternating Nystagmus Causes and Management Torsional Nystagmus Causes and Management Gaze-Evoked Nystagmus Mechanism Causes and Management Pendular Nystagmus Causes and Management Oculopalatal Myoclonus Mechanism Cause and Management See-Saw Nystagmus 3: Approach to Saccadic Oscillations: Opsoclonus and Ocular Flutter Definition Pathophysiological Classification of Saccadic Oscillations Saccadic Oscillations Secondary to Structural Deficits Saccadic Oscillations in a Structurally Intact Central Nervous System: The Role of Membrane Ion Channels Causes of Saccadic Oscillations Structural Lesions of Brainstem Hydrocephalus Multiple Sclerosis and Neurosarcoidosis Head Injury Parainfectious or Viral Bacterial Autoimmune Toxic and Metabolic Summary References 4: Eye Movements in Patients with Epilepsy Antiepileptic Induced Eye Movement Disorders Sodium Valproate Gaze-Evoked Nystagmus (GEN) Vertical Gaze Palsy Phenytoin/Fosphenytoin Gaze-Evoked Nystagmus Smooth Pursuit Vestibulo-Ocular Reflex Suppression Downbeat Nystagmus Periodic Alternating Nystagmus (PAN) Pendular Nystagmus Carbamazepine Gaze-Evoked Nystagmus Slowed Saccades Smooth Pursuit Downbeat Nystagmus Seesaw Nystagmus Oculogyric Crisis Ophthalmoplegia Lamotrigine Downbeat Nystagmus Benzodiazepines and Barbiturates Saccade Duration and Velocity Smooth Pursuit Propofol and Midazolam Saccade Latency and Velocity Ictal Eye Movement Disorders Versive Seizures Epileptic Nystagmus Epileptic Monocular Nystagmus Ictal Eye Blinking Summary References 5: Eye Movements in Coma Eyelid Movements Spontaneous Eye Movements Spontaneous Eye Movements That Are Exclusive to Comatose State Spontaneous Eye Movements in Unconscious Patients Spontaneous Eye Movements that Are Non-exclusive of Comatose State Reflexive Eye Movements in Unconscious Patients Summary References 6: Eye Movements and Vestibular Dysfunction: Lesions of Medulla Oblongata Acute Vestibular Syndrome Lateral Medullary Syndrome (Wallenberg’s Syndrome) Medial Medullary Syndrome Other Medullary Lesions Summary References 7: Eye Movements and Vestibular Dysfunction: Lesions of Cerebellum Lesions of Flocculus and Paraflocculus Lesions of Nodulus and Ventral Uvula Lesions of the Dorsal Vermis and Fastigial nuclei (FOR, Fastigial Oculomotor Region) Summary References 8: Eye Movements and Vestibular Dysfunction: Lesions of Pons Abducens Palsy Lesions of Paramedian Pontine Reticular Formation (PPRF) Medial Longitudinal Fasciculus (MLF) One-and-Half Syndrome and Its Variants Pontine Stroke Syndromes Raymond Syndrome Millard-Gubler Syndrome Foville Syndrome Raymond-Cestan Syndrome Summary References 9: Eye Movements and Vestibular Dysfunction: Lesions of Midbrain Rostral Interstitial Nucleus of the Medial Longitudinal Fasciculus (riMLF) Interstitial Nucleus of Cajal (INC) Posterior Commissure and Nucleus of the Posterior Commissure Superior Colliculus Oculomotor Nerve Palsy Nuclear IIIrd Nerve Palsy Fascicular IIIrd Nerve Palsy Trochlear Nerve Palsy Midbrain Stroke Syndromes Weber’s Syndrome Claude’s Syndrome Benedikt’s Syndrome Nothnagel’s Syndrome Summary References 10: Eye Movements and Vestibular Dysfunction: Lesions of Thalamus and Cerebral Cortex The Thalamus Central Thalamic Lesions Pulvinar Lesions Cerebral Cortex Posterior Occipital-Temporal Cortex Vestibular Cortex (Parieto-Insular-Vestibular Cortex, PIVC) Parietal Lobe Acquired Ocular Motor Apraxia Frontal Lobe Frontal Eye Field (FEF) Supplementary Eye Field (SEF) Dorsolateral Prefrontal Cortex (DLPC) Cingulate Eye Field (CEF) Summary References Index