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Degenerative Diseases of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
James A. Mastrianni, Elizabeth A. Harris
Cranial nerves: Reduced visual acuity.Optic atrophy.Eye movements: Square wave jerks at fixation.Saccadic intrusion upon smooth ocular pursuits (jerky pursuits).Gaze-evoked nystagmus.Reduced gain of vestibulo-ocular reflex.Speech: slurred, slow, staccato, and explosive (ataxic dysarthria).
Evaluation of Balance
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
The vestibulo-ocular reflex serves a very specific function: to stabilize gaze in space during head movements. The VOR is what allows us to see clearly when we walk, run or turn our heads. It does so by generating slow-phase eye movements of equal velocity, but opposite in direction, to head movement. This is achieved by a three-neuron, short latency, reflex: a Scarpa ganglion neuron, a vestibular nucleus neuron and an oculomotor nuclear neuron (III, IV or VI).
The Central Nervous System Organization of Behavior
Published in Rolland S. Parker, Concussive Brain Trauma, 2016
The vestibulocerebellum receives afferents from the vestibular nuclei (see above). It coordinates an individual’s ability to use vestibular information to control eye movements (Ghez & Thach, 2000). The vestibulo-ocular reflex involves the vestibular system’s perception of head movement and causes the eyeball to move in the opposite direction.
Training high level balance and stepping responses in atypical progressive supranuclear palsy: a case report
Published in Physiotherapy Theory and Practice, 2023
Earllaine Croarkin, Krystle Robinson, Christopher J. Stanley, Cris Zampieri
The methods we utilized for foot clearance analysis were a modification of those pioneered by Di Fabio, Zampieri, and Tuite (2008) in patients with PSP. Although our patient was atypical given his preserved function, foot clearance deficits seemed to fall under the typical presentation of PSP and revealed concerns of gaze deficits influencing his ability to coordinate stepping responses. There is evidence in patients with PSP that gaze deficits negatively affect foot clearance (Di Fabio, Zampieri, and Tuite, 2008). In a comparison of two groups of patients with PSP, those with severe gaze deficits demonstrated significantly reduced trailing foot clearance on a stepping task versus those with mild oculomotor deficits (Di Fabio, Zampieri, and Tuite, 2008). During foot clearance analysis, as he approached the wooden platform and/or box, his head would pitch down in an attempt to look at the wooden box, but his eyes appeared to counter rotate up, demonstrating a fixated gaze at the horizon. Suppression of the vestibular-ocular reflex is a phenomenon that has been previously documented (Di Fabio, Zampieri, and Tuite, 2007). This leads to restrictions in patients’ downward gaze and their ability to localize objects on the ground during stepping activity. Not surprisingly, one of our patient’s subjective complaints was that his eyes would get “stuck” while he was walking his dog.
An upper cervical spine treatment protocol for cervicogenic dizziness: a randomized controlled trial
Published in Physiotherapy Theory and Practice, 2022
Andoni Carrasco-Uribarren, Jacobo Rodríguez-Sanz, Carlos López-de-Celis, Pablo Fanlo-Mazas, Sara Cabanillas-Barea
The cervico-ocular, vestibulo-ocular, and optokinetic reflexes work together to control the extraocular muscles. These systems help to create a clear view of images during head movement (Treleaven, Jull, and Grip, 2011). Different cervical problems can alter these reflexes and give symptoms such as dizziness and headache (Treleaven, 2008, 2011). In vestibular rehabilitation, practitioners try to improve patients’ vestibulo-ocular reflex. The goal of gaze stabilization exercises is to improve the patients’ gain of the impaired vestibulo-ocular reflex. To do this, head mobility exercises are performed with the gaze fixed on an object. This tends to improve stability and decrease the feeling of dizziness in patients (Whitney and Sparto, 2011). The present study shows improvements in the cervical range of motion during the fixed gaze test for the T1 (p < .050) and T2 (p < .001) follow-ups in the intervention group. It may be that the decrease in neck pain contributes to performing this test correctly with a higher range of motion.
Effect of an oculomotor rehabilitation program for subacute brain injury patients with ophthalmoplegia: a case-control study
Published in Disability and Rehabilitation, 2022
Takayuki Watabe, Hisayoshi Suzuki, Rikitaro Sako, Marina Abe, Keiichiro Aoki, Mitsumasa Yoda
A cross-sectional study on rehabilitation interventions for external ophthalmoplegia suggested therapeutic strategies, including the use of visual devices, examining compensatory measures, and facilitative methods based on brain plasticity [3]. Three randomized controlled trials (cross-over experimental design) have verified the effects of a computer oculomotor rehabilitation (COR) program package [4–6], and a few other studies have reported the use of this program in stroke and head injury patients [7–9]. This program involves moving the eyes in synchronization with a target displayed on a computer screen and is particularly aimed at promoting pursuit, fixation, and saccade. Kawahira et al. [10] demonstrated the effects of a repetitive facilitative therapeutic program that used the vestibulo-ocular reflex in a case series. In this method, the patient is instructed to look continuously at the therapist with one eye while the therapist repeatedly performs maneuvers that cause the patient’s face to rotate by 30–45 degrees.