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“The Eyes Have It”: Saccades and Fixation Defects in Movement Disorders

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Movement Disorders Phenomenology

Abstract

The examination of eye movements, and in particular the examination of saccades, is a critical part of the movement disorders examination. Saccadic slowing may be the first sign of an atypical parkinsonian state or of Huntington’s disease, and other eye movement disorders such as ocular flutter or opsoclonus may affect management acutely.

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References

  1. Termsarasab P, Thammongkolchai T, Rucker JC, Frucht SJ. The diagnostic value of saccades in movement disorder patients: a practical guide and review. J Clin Mov Disord. 2015;2:14. https://doi.org/10.1186/s40734-015-0025-4.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Patel SS, Jankovic J, Hood AJ, Jeter CB, Sereno AB. Reflexive and volitional saccades: biomarkers of Huntington disease severity and progression. J Neurol Sci. 2012;313(1–2):35–41. https://doi.org/10.1016/j.jns.2011.09.035.

    Article  PubMed  Google Scholar 

  3. Leigh RJ, Zee DS. The neurology of eye movements. 5th ed. New York: Oxford University Press; 2015.

    Book  Google Scholar 

  4. Aicardi J, Barbosa C, Andermann E, Andermann F, Morcos R, Ghanem Q, et al. Ataxia-ocular motor apraxia: a syndrome mimicking ataxia-telangiectasia. Ann Neurol. 1988;24(4):497–502. https://doi.org/10.1002/ana.410240404.

    Article  CAS  PubMed  Google Scholar 

  5. Gascon GG, Abdo N, Sigut D, Hemidan A, Hannan MA. Ataxia-oculomotor apraxia syndrome. J Child Neurol. 1995;10(2):118–22.

    Article  CAS  Google Scholar 

  6. Criscuolo C, Chessa L, Di Giandomenico S, Mancini P, Sacca F, Grieco GS, et al. Ataxia with oculomotor apraxia type 2: a clinical, pathologic, and genetic study. Neurology. 2006;66(8):1207–10. https://doi.org/10.1212/01.wnl.0000208402.10512.4a.

    Article  CAS  PubMed  Google Scholar 

  7. Le Ber I, Moreira MC, Rivaud-Pechoux S, Chamayou C, Ochsner F, Kuntzer T, et al. Cerebellar ataxia with oculomotor apraxia type 1: clinical and genetic studies. Brain. 2003;126(Pt 12):2761–72. https://doi.org/10.1093/brain/awg283.

    Article  PubMed  Google Scholar 

  8. Pearson TS. More than Ataxia: hyperkinetic movement disorders in childhood autosomal recessive Ataxia syndromes. Tremor Other Hyperkinet Mov (N Y). 2016;6:368. https://doi.org/10.7916/D8H70FSS.

    Article  Google Scholar 

  9. Steele JC, Richardson JC, Olszewski J. Progressive supranuclear palsy. A heterogeneous degeneration involving the brain stem, basal ganglia and cerebellum with vertical gaze and pseudobulbar palsy, nuchal dystonia and dementia. Arch Neurol. 1964;10:333–59. https://doi.org/10.1001/archneur.1964.00460160003001.

    Article  CAS  PubMed  Google Scholar 

  10. Bhidayasiri R, Riley DE, Somers JT, Lerner AJ, Buttner-Ennever JA, Leigh RJ. Pathophysiology of slow vertical saccades in progressive supranuclear palsy. Neurology. 2001;57(11):2070–7.

    Article  CAS  Google Scholar 

  11. Shiozawa M, Fukutani Y, Sasaki K, Isaki K, Hamano T, Hirayama M, et al. Corticobasal degeneration: an autopsy case clinically diagnosed as progressive supranuclear palsy. Clin Neuropathol. 2000;19(4):192–9.

    CAS  PubMed  Google Scholar 

  12. Rusina R, Kovacs GG, Fiala J, Hort J, Ridzon P, Holmerova I, et al. FTLD-TDP with motor neuron disease, visuospatial impairment and a progressive supranuclear palsy-like syndrome: broadening the clinical phenotype of TDP-43 proteinopathies. A report of three cases. BMC Neurol. 2011;11:50. https://doi.org/10.1186/1471-2377-11-50.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Huber FM, Bour F, Sazdovitch V, Hauw JJ, Heinemann U, Zanini F et al. Creutzfeldt-Jakob disease with slow progression. A mimickry of progressive supranuclear palsy. Bulletin de la Societe des sciences medicales du Grand-Duche de Luxembourg. 2007(2):125–30.

    Google Scholar 

  14. Petrovic IN, Martin-Bastida A, Massey L, Ling H, O’Sullivan SS, Williams DR, et al. MM2 subtype of sporadic Creutzfeldt-Jakob disease may underlie the clinical presentation of progressive supranuclear palsy. J Neurol. 2013;260(4):1031–6. https://doi.org/10.1007/s00415-012-6752-7.

    Article  PubMed  Google Scholar 

  15. Prasad S, Ko MW, Lee EB, Gonatas NK, Stern MB, Galetta S. Supranuclear vertical gaze abnormalities in sporadic Creutzfeldt-Jakob disease. J Neurol Sci. 2007;253(1–2):69–72. https://doi.org/10.1016/j.jns.2006.11.010.

    Article  PubMed  Google Scholar 

  16. Di Fonzo A, Chien HF, Socal M, Giraudo S, Tassorelli C, Iliceto G, et al. ATP13A2 missense mutations in juvenile parkinsonism and young onset Parkinson disease. Neurology. 2007;68(19):1557–62. https://doi.org/10.1212/01.wnl.0000260963.08711.08.

    Article  CAS  PubMed  Google Scholar 

  17. Newsway V, Fish M, Rohrer JD, Majounie E, Williams N, Hack M, et al. Perry syndrome due to the DCTN1 G71R mutation: a distinctive levodopa responsive disorder with behavioral syndrome, vertical gaze palsy, and respiratory failure. Mov Disord. 2010;25(6):767–70. https://doi.org/10.1002/mds.22950.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Fenollar F, Puechal X, Raoult D. Whipple’s disease. N Engl J Med. 2007;356(1):55–66. https://doi.org/10.1056/NEJMra062477.

    Article  CAS  PubMed  Google Scholar 

  19. Salsano E, Umeh C, Rufa A, Pareyson D, Zee DS. Vertical supranuclear gaze palsy in Niemann-Pick type C disease. Neurol Sci. 2012;33(6):1225–32. https://doi.org/10.1007/s10072-012-1155-1.

    Article  PubMed  Google Scholar 

  20. Wadia NH, Swami RK. A new form of heredo-familial spinocerebellar degeneration with slow eye movements (nine families). Brain. 1971;94(2):359–74.

    Article  CAS  Google Scholar 

  21. Benko W, Ries M, Wiggs EA, Brady RO, Schiffmann R, Fitzgibbon EJ. The saccadic and neurological deficits in type 3 Gaucher disease. PLoS One. 2011;6(7):e22410. https://doi.org/10.1371/journal.pone.0022410.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Quinn N. The “round the houses” sign in progressive supranuclear palsy. Ann Neurol. 1996;40(6):951. https://doi.org/10.1002/ana.410400630.

    Article  CAS  PubMed  Google Scholar 

  23. Briand KA, Strallow D, Hening W, Poizner H, Sereno AB. Control of voluntary and reflexive saccades in Parkinson’s disease. Exp Brain Res. 1999;129(1):38–48.

    Article  CAS  Google Scholar 

  24. Rottach KG, Riley DE, DiScenna AO, Zivotofsky AZ, Leigh RJ. Dynamic properties of horizontal and vertical eye movements in parkinsonian syndromes. Ann Neurol. 1996;39(3):368–77. https://doi.org/10.1002/ana.410390314.

    Article  CAS  PubMed  Google Scholar 

  25. White OB, Saint-Cyr JA, Tomlinson RD, Sharpe JA. Ocular motor deficits in Parkinson’s disease. II. Control of the saccadic and smooth pursuit systems. Brain. 1983;106(Pt 3):571–87.

    Article  Google Scholar 

  26. Anderson T, Luxon L, Quinn N, Daniel S, Marsden CD, Bronstein A. Oculomotor function in multiple system atrophy: clinical and laboratory features in 30 patients. Mov Disord. 2008;23(7):977–84. https://doi.org/10.1002/mds.21999.

    Article  PubMed  Google Scholar 

  27. Hasegawa S, Matsushige T, Kajimoto M, Inoue H, Momonaka H, Oka M, et al. A nationwide survey of opsoclonus-myoclonus syndrome in Japanese children. Brain Dev. 2014;37:656. https://doi.org/10.1016/j.braindev.2014.10.010.

    Article  PubMed  Google Scholar 

  28. Morita A, Ishihara M, Kamei S, Ishikawa H. Opsoclonus-myoclonus syndrome following influenza a infection. Intern Med. 2012;51(17):2429–31.

    Article  CAS  Google Scholar 

  29. Sheth RD, Horwitz SJ, Aronoff S, Gingold M, Bodensteiner JB. Opsoclonus myoclonus syndrome secondary to Epstein-Barr virus infection. J Child Neurol. 1995;10(4):297–9.

    Article  CAS  Google Scholar 

  30. Brissaud HE, Beauvais P. Opsoclonus and neuroblastoma. N Engl J Med. 1969;280(22):1242.

    CAS  PubMed  Google Scholar 

  31. Laroumagne S, Elharrar X, Coiffard B, Plojoux J, Dutau H, Breen D, et al. “Dancing eye syndrome” secondary to opsoclonus-myoclonus syndrome in small-cell lung cancer. Case Rep Med. 2014;2014:545490. https://doi.org/10.1155/2014/545490.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Rossor AM, Perry F, Botha A, Norwood F. Opsoclonus myoclonus syndrome due to squamous cell carcinoma of the oesophagus. BMJ Case Rep. 2014;2014 https://doi.org/10.1136/bcr-2013-202849.

  33. Sandok BA, Kranz H. Opsoclonus as the initial manifestation of occult neuroblastoma. Arch Ophthalmol. 1971;86(2):235–6.

    Article  CAS  Google Scholar 

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Correspondence to Steven J. Frucht .

Electronic Supplementary Material

This Chapter reviews the important role that eye movements play in the evaluation of the movement disorders patient. The video is divided into eight segments: saccades in PSP; asaccadia after aortic aneurysm repair; saccades in HD; saccades in choreic neurodegenerative disorders; eye movements in multiple system atrophy; macrosaccadic oscillations in Friedreich’s ataxia; eye movement abnormalities in genetic ataxias; and assorted saccadic disorders (MP4 1913752 kb)

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Frucht, S.J., Termsarasab, P. (2020). “The Eyes Have It”: Saccades and Fixation Defects in Movement Disorders. In: Movement Disorders Phenomenology. Springer, Cham. https://doi.org/10.1007/978-3-030-36975-0_12

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  • DOI: https://doi.org/10.1007/978-3-030-36975-0_12

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