PubMed · 14445351
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B SHACKEL. 1960. Pilot study in electro-oculography.. https://doi.org/10.1136/bjo.44.2.89
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Macrosquare-wave jerks consist of high-amplitude saccadic intrusions occurring mainly during fixation that are observed in several disease entities, e.g., multiple sclerosis or parkinsonian syndromes, but very rarely in patients with multiple system atrophy. We present here a patient with multiple system atrophy exhibiting the oculomotor feature of macrosquare-wave jerks.
OBJECTIVES: To investigate whether vibrational impulse stimuli applied to the skull can be used to evoke the vestibulo-ocular reflex (VOR) and detect vestibular lesions. METHODS: Twenty four patients with unilateral vestibular loss (UVD), five with bilateral vestibular loss, two with ocular palsies, and 10 healthy subjects participated. Vibrations of the skull were induced with head taps and with a single period of 160 Hz tone burst on the inion, vertex, and the mastoids while the patients viewed a distant target. Several patients were also examined while viewing a near target, with eccentric gaze and in tilted postures. Responses were recorded by EOG. RESULTS: Responses occurred between 5 ms and 20 ms and seemed to be compensatory to the second phase of the sine wave of vibration impulse and were greatly diminished/absent in patients with bilateral VD and ocular palsies. The patients with UVD had asymmetrical responses in the vertical EOG with stimuli applied on the inion and vertex, with enhancement of the response amplitude on the side of vestibular loss and/or diminution on the healthy side. The asymmetry ratios between the healthy subjects and patients with UVD, and among patients with UVD were statistically significant. Some gaze and positional influences could be demonstrated consistent with otolithic reflexes. CONCLUSION: If the asymmetric responses to skull vibration in UVD result from passive oscillatory movements of the orbital tissues they may reflect the otolith mediated sustained skew torsion. Conversely, if generated by active eye movements, their likely origin is a phasic VOR.
PURPOSE: To report optical coherence tomography (OCT) changes in Best's vitelliform macular dystrophy (BVMD) with pseudohypopyon. DESIGN: Observational case report. METHODS: Both eyes of a patient with BVMD showing pseudohypopyon were examined with OCT. RESULTS: OCT demonstrated the presence of serous retinal elevation with normal appearing retinal pigment epithelium (RPE) superiorly, and broadening of the outer-retina-choroid-complex signal under retinal elevation, inferiorly. CONCLUSIONS: OCT findings in our study suggest the accumulation of material under neurosensory retina in BVMD with pseudohypopyon.