Video Gallery

222 Videos

Anton Syndrome

Legend: Video shows a 48-year-old man with complete loss of vision following bilateral occipital cardioembolic strokes. He denied blindness and said he felt “super.” He confabulated that he could see objects in front of him but when asked to describe them in detail, said “I don’t know how to tell.” He had no difficulty identifying objects when he held them in his hand. Even following demonstrations that he was not seeing properly, he insisted “my vision is OK.”

Duration: 2:52

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(5):1329-1361, October 2019 October 2020, Volume 26, Issue 5;

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Anton Syndrome
Anton Syndrome

Legend: Video shows a 48-year-old man with complete loss of vision following bilateral occipital cardioembolic strokes. He denied blindness and said he felt “super.” He confabulated that he could see objects in front of him but when asked to describe them in detail, said “I don’t know how to tell.” He had no difficulty identifying objects when he held them in his hand. Even following demonstrations that he was not seeing properly, he insisted “my vision is OK.”

Duration: 2:52

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(5):1329-1361, October 2019 October 2020, Volume 26, Issue 5;

Published on: 10.09.2019

Apperceptive Visual Agnosia
Apperceptive Visual Agnosia

Legend: Video shows a 23-year-old woman who developed severe visual impairments after hypoxic arrest from a narcotic overdose. She described her vision as distorted or blurred. She could tell an object was in front of her but could not tell what it was. Faces were “completely distorted.” She could not identify any visually presented objects, read letters, or copy simple line drawings correctly. Visual acuity, tested with the preferential looking test (patient directs the eyes toward a set of black-and white stripes, in which the thickness of the stripes in some examples approximates 20/20 vision) was normal; she had no other cognitive deficits.

Duration: 1:59

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(5):1329-1361, October 2019

Published on: 10.09.2019

Central Hemiachromatopsia
Central Hemiachromatopsia

Legend: Video shows a 57-year-old woman who presented with a left superior quadrant homonymous field deficit due to a right inferior occipital stroke. Examination showed that she was unable to discriminate colors in the left inferior homonymous field, saying that cards of various colors shown in that area were gray or white. Diffusion-weighted MRI showed acute right inferior occipital infarction, involving the inferior bank of area V1 and area V4.

Duration: 1:50

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(5):1329-1361, October 2019

Published on: 10.09.2019

Alexia Without Agraphia
Alexia Without Agraphia

Legend: Video shows a 41-year-old man with an infiltrating glioma involving the left occipital lobe and splenium of the corpus callosum with a profound inability to read words with both regular or irregular phonemic spelling, although writing and spoken language remained normal. He was unable to read a sentence he had written himself, saying “I don’t know; it’s almost like I didn’t write it.” The examination also demonstrated a right superior greater than inferior homonymous hemianopia.

Duration: 2:18

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(5):1329-1361, October 2019

Published on: 10.09.2019

Prosopagnosia
Prosopagnosia

Legend: Video shows a 37-year-old woman with difficulty distinguishing faces due to breast cancer metastasis involving the right occipitotemporal cortex in the fusiform face area. She said that faces look “smoother and less defined.” She called it the “Instagram filter” in her brain.

Duration: 2:22

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(5):1329-1361, October 2019

Published on: 10.09.2019

Riddoch Syndrome
Riddoch Syndrome

Legend: Video shows a 15-year-old girl who developed a dense right homonymous visual field deficit after left posterior cerebral artery stroke following a traumatic head injury with expansion of an epidural hematoma. As she recovered, she found that she could detect motion in the otherwise blind field. Static Humphrey automated perimetry testing demonstrated the right homonymous field defect.

Duration: 1:28

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(5):1329-1361, October 2019

Published on: 10.09.2019

Balint Syndrome
Balint Syndrome

Legend: Video shows a 70-year-old woman who reported difficulty reaching for things. She could read but had difficulty moving from one word to the next and felt confused when she entered a place with complex visual stimuli. When asked what letter she saw in a picture of an H made of little As, she answered “A,” even when directed to look at the whole picture. Examination revealed ocular apraxia, optic ataxia, and simultagnosia, leading to a diagnosis of Balint syndrome.

Duration: 0:48

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(5):1329-1361, October 2019

Published on: 10.09.2019

Charles Bonnet Syndrome
Charles Bonnet Syndrome

Legend: Video shows a 93-year-old woman with severe visual loss from macular degeneration and glaucoma had frequent complex visual hallucinations. She described seeing “a little blond dressed very nice…in a wool plaid suit, skirt, and jacket, and curly, curly hair and big, round eyes.” The hallucinations were nonthreatening, and she had no auditory hallucinations.

Duration: 1:42

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(5):1329-1361, October 2019

Published on: 10.09.2019

Lhermitte Peduncular Hallucinosis
Lhermitte Peduncular Hallucinosis

Legend: Video shows a 66-year-old man with the sudden onset of vivid visual hallucinations during wakefulness following bariatric surgery. Apart from describing the hallucinations, he was alert, attentive, and fully oriented without any confusion. He described seeing in his hospital room, for example, synchronized swimmers, snakes crawling up to the bed, numbers melting off the clock, and plumes of smoke at the nursing station. Diffusion-weighted imaging (DWI) and apparent diffusion coefficient MRI demonstrated a mesencephalic stroke, consistent with a diagnosis of peduncular hallucinosis.

Duration: 1:36

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(5):1329-1361, October 2019

Published on: 10.09.2019

Jerk Nystagmus
Jerk Nystagmus

Legend: Video shows unidirectional left-beat jerk nystagmus in a patient with multiple sclerosis with a demyelinating lesion of the right vestibular nuclei. The pathologic component of the nystagmus is repetitive slow drifting of the eyes toward the right followed by corrective resetting fast phases toward the left, after which the nystagmus is named.

Duration: 0:33

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(5):1376-1400, October 2019

Published on: 10.09.2019

Acquired Pendular Nystagmus
Acquired Pendular Nystagmus

Legend: Video shows acquired pendular nystagmus in a patient with multiple sclerosis with chronic optic nerve demyelination and diffuse cortical and posterior fossa demyelinating lesions. In the upper black-and-white eye movement videos, note the predominantly horizontal sinusoidal back-to-back slow oscillations without any fast phases. The bottom portions of the video show the eye position (red line is horizontal eye position, blue line is vertical eye position) and velocity (purple and green lines) traces of the nystagmus. The sinusoidal oscillation in the red line corresponds to the horizontal oscillations of the eyes. A slight vertical oscillation is also seen.

Duration: 0:49

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(5):1376-1400, October 2019

Published on: 10.09.2019

Ocular Flutter and Opsoclonus
Ocular Flutter and Opsoclonus

Legend: The first video segment shows ocular flutter, and the second video segment shows opsoclonus in a patient with a parainfectious brainstem encephalitis, with subacute onset oscillopsia, ataxia, and truncal myoclonus. No specific infectious organism was identified. Neoplastic and paraneoplastic evaluation was unremarkable. Recovery occurred over 3 months. In the video, flutter transitions to opsoclonus at 33 seconds.

Duration: 1:50

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(5):1376-1400, October 2019

Published on: 10.09.2019

Acquired Pendular Nystagmus in Multiple Sclerosis
Acquired Pendular Nystagmus in Multiple Sclerosis

Legend: Video shows acquired pendular nystagmus in a patient with multiple sclerosis. The first video segment shows minimal to no movement in the right eye and small horizontal pendular oscillations in the left eye. The second segment shows a magnified view of the right eye, with minimal to no visible movement in the right eye. The third segment shows a magnified view of the left eye, with small horizontal pendular oscillations. The fourth video segment shows marked saccadic hypermetria, evidence that this patient also had cerebellar dysfunction, as is typical of most patients with acquired pendular nystagmus from multiple sclerosis.

Duration: 1:16

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(5):1376-1400, October 2019

Published on: 10.09.2019

Acquired Pendular Nystagmus in Oculopalatal Myoclonus
Acquired Pendular Nystagmus in Oculopalatal Myoclonus

Legend: The first video segment shows oculopalatal myoclonus with large vertical pendular nystagmus, and the second video segment shows palatal myoclonus in a patient who developed severe oscillopsia several months after a brainstem stroke. In the first segment, note the lack of horizontal eye movement from the original pontine infarction. Vertical range of eye motion is full.

Duration: 2:12

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(5):1376-1400, October 2019

Published on: 10.07.2019

Posterior Canal Benign Paroxysmal Positional
Posterior Canal Benign Paroxysmal Positional

Legend: Video demonstrates the nystagmus seen in a positive Dix-Hallpike maneuver in a patient with right posterior canal benign paroxysmal positional vertigo. When the patient is rapidly positioned supine with the right ear down, torsional upbeat nystagmus begins after a short delay, with the torsional component manifested as the top poles of the eyes beating toward the right ear. Note the fatigable intensity of the nystagmus over time. Frenzel goggles eliminate the patient’s ability to fixate and enhance the view of the examiner, although this type of nystagmus will typically be visible without Frenzel goggles.

Duration: 00:37

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(5):1376-1400, October 2019

Published on: 10.07.2019

Periodic Alternating Nystagmus
Periodic Alternating Nystagmus

Legend: The first video segment shows the left-beat component of periodic alternating nystagmus in a patient with multiple sclerosis who had oscillopsia; the second video segment shows the right-beat component. Transitioning between right-beat and left-beat nystagmus occurred every 90 seconds. Treatment with baclofen stopped the nystagmus completely.

Duration: 00:41

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(5):1376-1400, October 2019

Published on: 10.07.2019

Upbeat Nystagmus
Upbeat Nystagmus

Legend: Video shows a patient with Wernicke encephalopathy with upbeat nystagmus in the central position that, in keeping with the Alexander law, increases in upgaze. Bilateral horizontal ocular motor range limitations are also present, with incomplete right eye abduction and incomplete left eye abduction and adduction.

Duration: 00:52

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(5):1376-1400, October 2019

Published on: 10.07.2019

Downbeat Nystagmus
Downbeat Nystagmus

Legend: A patient with a Chiari I malformation exhibits downbeat nystagmus in downgaze. Magnified view of the right eye exhibits a trace amount of downbeat nystagmus in right downward gaze. The downbeat nystagmus is more obvious in left downward gaze. High-resolution infrared video shows downbeat nystagmus in down and lateral gaze. At the end of the video, the downbeat nystagmus is visualized in the central position.

Duration: 00:53

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(5):1376-1400, October 2019

Published on: 10.07.2019

Gaze-Evoked Nystagmus
Gaze-Evoked Nystagmus

Legend: Video shows pathologic gaze-evoked nystagmus in a patient with a Chiari I malformation. The first segment shows right-beat nystagmus in right gaze, the second segment shows left-beat nystagmus in left gaze followed by rebound right-beat nystagmus upon return to central position and rebound nystagmus, and the third segment shows downbeat nystagmus.

Duration: 0:55

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(5):1376-1400, October 2019

Published on: 10.07.2019

Ocular Flutter
Ocular Flutter

Legend: Video shows a patient with runs of back-to-back horizontal saccades, consistent with ocular flutter. Note that in this patient, they were elicited by voluntary lateral saccades. Ocular flutter typically occurs in the setting of cerebellar disease, either from an infectious or parainfectious cerebellitis or paraneoplastic disease.

Duration: 00:31

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(5):1401-1421, October 2019

Published on: 10.07.2019

Opsoclonus
Opsoclonus

Legend: Video shows a patient with runs of back-to-back saccades in all directions, consistent with opsoclonus. Opsoclonus consists of high-frequency saccadic movements that may be of large amplitude and lack an intersaccadic interval. It localizes to brainstem or cerebellar damage, often resulting from paraneoplastic disease, with or without myoclonus, typically from neuroblastoma in children and small cell lung carcinoma or ovarian cancer in adults.

Duration: 00:26

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(5):1401-1421, October 2019

Published on: 10.07.2019

Chorea-acanthocytosis
Chorea-acanthocytosis

Legend: Video shows a 36-year-old woman with chorea-acanthocytosis. The first video segment demonstrates severe tongue protrusion or feeding dystonia. In the second segment, she exhibits a mild parkinsonian appearance and lower facial and left arm dystonia, but only mild truncal chorea. She walks with stutter steps and has circumduction of the left leg.

Duration: 0:53

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(4):1001-1035, August 2019

Published on: 08.02.2019

Different degrees of gait ataxia
Different degrees of gait ataxia

Legend: The first video segment shows an 18-year-old man with ataxia with oculomotor apraxia type 2. Mild gait ataxia can manifest with variable step length, side steps, and veering toward one side without a marked wide base. The second video segment shows a 37-year-old man with idiopathic cerebellar ataxia. In patients with moderate ataxia, the gait becomes wide based with obvious variable stride lengths. The third video segment shows a 32-year-old woman with spinocerebellar ataxia type 2. In the advanced stages of ataxia, a wide-based gait is more evident, and the stride length becomes shorter to compensate for ataxia.

Duration: 1:16

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(4):1036-1054, August 2019

Published on: 08.02.2019

Multiple system atrophy, cerebellar type
Multiple system atrophy, cerebellar type

Legend: Video shows the 56-year-old woman who developed imbalance and walked “as if she were drunk.” She veered toward one side while walking, had two episodes of syncope, and her speech and hand dexterity were subsequently involved. On examination, she has hypomimic facial expression, hypermetric saccades, dysmetria on finger-nose-finger tests, bradykinesia in finger taps, and ataxic gait with variable footsteps. Her postmortem brain pathology demonstrated glial cytoplasmic inclusions along with olivopontocerebellar atrophy, confirming the diagnosis of multiple system atrophy, cerebellar type.

Duration: 1:00

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(4):1036-1054, August 2019

Published on: 08.02.2019

Spinocerebellar ataxia type 2
Spinocerebellar ataxia type 2

Legend: The first video segment shows the 55-year-old woman with spinocerebellar ataxia type 2. She has limited upward gaze and slow saccadic eye movements without nystagmus or hypermetric or hypometric saccades. She has dysmetria on finger-nose-finger tests and an overshoot in finger chase tests. She also has impaired rapid alternating movements. Her facial expression is hypomimic, and her gait is wide based and shows variable stride length. The second video segment shows the same patient 5 years later. Her symptoms have progressed. She has ophthalmoparesis, particularly in vertical gaze, and her saccadic eye movements have become very slow.

Duration: 2:04

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(4):1036-1054, August 2019

Published on: 08.02.2019

Niemann-Pick disease type C
Niemann-Pick disease type C

Legend: Video shows a 30-year-old man with Niemann-Pick disease type C. He has relatively preserved smooth pursuit in the horizontal direction without end-gaze nystagmus. He can perform upward pursuit, but his downward pursuit movements are extremely slow. He also has relatively preserved horizontal saccades and has great difficulty in vertical saccades, particularly in the downward direction.

Duration: 0:51

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(4):1036-1054, August 2019

Published on: 08.02.2019

Tardive dyskinesia and tardive dystonia
Tardive dyskinesia and tardive dystonia

Legend: Video shows the 64-year-old woman discussed in Case 9-2 exhibiting continuous chewing movements, lip puckering, blepharospasm, and left leg stereotypies indicative of tardive dyskinesia and tardive dystonia. Her posture reveals moderate torticollis, with her head rotated to her right and the right shoulder mildly elevated. The patient’s movement disorder is generalized, involving face, neck, and trunk.

Duration: 1:13

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(4):1081-1098, August 2019

Published on: 08.02.2019

Mild, segmental tardive dystonia with associated tachypnea
Mild, segmental tardive dystonia with associated tachypnea

Legend: Video shows a 70-year-old man with mild, segmental tardive dystonia exhibiting irregular contractions of the corners of his mouth, asymptomatic tachypnea, and a masked facial expression. The mouth movements are dystonic in nature, and he has no other signs of a tardive syndrome. He had been treated with chlorpromazine, risperidone, and other antipsychotics for several decades. His movements developed when risperidone was changed to quetiapine. At the time of this video, the patient was taking risperidone 0.5 mg twice daily and tetrabenazine 12.5 mg twice daily.

Duration: 0:50

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(4):1081-1098, August 2019

Published on: 08.02.2019

Speech examination in a woman with primary progressive apraxia of speech.
Speech examination in a woman with primary progressive apraxia of speech.

Legend: Video shows a 70-year-old woman with primary progressive apraxia of speech. Speech alternating motion rates are slow but reasonably accurate. When combining sounds during speech sequential motion rates, a slow rate is required for accurate enunciation. During word repetition, evidence of groping, distortions, and substitutions is seen. This patient had minimal intelligible verbal output during picture description but tested normally on all language measures when written responses were allowed (not shown on video).

Duration: 2:02

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(1):101-127, February 2019

Published on: 02.01.2019

Language examination in a woman with nonfluent/agrammatic variant primary progressive aphasia.
Language examination in a woman with nonfluent/agrammatic variant primary progressive aphasia.

Legend: Video shows a 68-year-old woman with nonfluent/ agrammatic variant primary progressive aphasia. Agrammatic and telegraphic speech is evident in response to a simple question (“Why are you here?”) and during picture description. Specifically, the first sentence in her response is clearly agrammatic: “Well, I not say the words.” She also omits and and incorrectly uses is when she describes the couple as: “The mother dad is picnicking.” Also, notice the presumed omission during the final sentence: “The radio is probably music.”

Duration: 2:18

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(1):101-127, February 2019

Published on: 02.01.2019

Language examination in a man with semantic variant primary progressive aphasia
Language examination in a man with semantic variant primary progressive aphasia

Legend: Video shows a 68-year-old man with semantic variant primary progressive aphasia. During picture description the patient uses a nonspecific word in several instances, such as something for wine, flower thing for kite, over there for dock, and something for sand. When reading irregular words, he regularizes the word in several instances (surface dyslexia). During object naming, he first calls a screwdriver a pen, and, even after holding it, he cannot name it. He does not benefit from a phonetic cue and appears not to recognize the object.

Duration: 2:22

Associated with: CONTINUUM: Lifelong Learning in Neurology. 25(1):101-127, February 2019

Published on: 02.01.2019

Progressive Supranuclear Palsy–Parkinsonism
Progressive Supranuclear Palsy–Parkinsonism

Legend: A 65-year-old man with hypophonic and dysarthric speech and masked facial expression. Vertical saccades are reduced and horizontal saccades slowed. He has moderate bradykinesia of hand movements, finger tapping, and rigidity in the limbs. Gait is stooped and slow, and his stance is narrowed and unstable. Pull test reveals minimal to no compensation.

Duration: 4:03

Associated with: CONTINUUM: Lifelong Learning in Neurology. 22(4):1117-1142, August 2016

Published on: 11.10.2017

Psychogenic Nonepileptic Seizure Induced by Photic Stimulation and Verbal Suggestion
Psychogenic Nonepileptic Seizure Induced by Photic Stimulation and Verbal Suggestion

Legend: The documented features of suggestibility (intensifying ictal manifestations with increasing photic frequency), somatic expression of distress (coughing, semifetal posture), and clinical unresponsiveness despite EEG demonstration (not shown) of an intact posterior dominant rhythm (reflecting an awake state) are all supportive of a psychogenic etiology to this captured nonepileptic seizure.

Duration: 2:18

Associated with: CONTINUUM: Lifelong Learning in Neurology. 22(1):15-37, February 2016

Published on: 11.10.2017

Neuromyotonia
Neuromyotonia

Legend: EMG recording from a middle-aged man includes multiple repeating discharges, each composed of multiple muscle fiber potentials with varying interpotential intervals corresponding to a firing frequency of up to 200 Hz.

Duration: 0:37

Associated with: October 2017, Volume 23, Issue 5;

Published on: 11.09.2017

Mildly abnormal intracranial pressure (ICP) waveform.
Mildly abnormal intracranial pressure (ICP) waveform.

Legend: Mild, abnormal ICP waveform during external ventricular drain (EVD) clamp trial with clustering of P1 to P3 waves. Respiratory variations are noted as well as Valsalva maneuver. The patient has muscle resistance testing of his deltoid, which causes the patient to perform the Valsalva maneuver and transiently increase ICP. Inspiration causes a decrease in ICP, and Valsalva maneuver during segmental muscle strength testing increases it.

Duration: 2:23

Associated with: CONTINUUM: Lifelong Learning in Neurology. 21(5):1299-1323, October 2015

Published on: 10.07.2015

Low compliance and high elastance
Low compliance and high elastance

Legend: The ICP waveform shown demonstrates a value of greater than 20 mm Hg and is frankly triangular with a low compliance/high elastance appearance. CSF is drained from the external ventricular drain (EVD) system (line goes flat for a while) and is later reopened periodically. By draining CSF, this essentially changes the ICP waveform by moving down and left on the elastance curve. Later, the ICP waveform returns after the external ventricular drain is opened and some P wave components are seen. However, it is important to recognize that the ICP waveform still has an overall noncompliant morphology indicative of a persistent abnormal intracranial pressure-volume state.

Duration: 2:22

Associated with: CONTINUUM: Lifelong Learning in Neurology. 21(5):1299-1323, October 2015

Published on: 10.07.2015

Edrophonium (Tensilon) Test in Myasthenia Gravis
Edrophonium (Tensilon) Test in Myasthenia Gravis

Legend: A 64-year-old man with acetylcholine receptor antibody positive myasthenia gravis. After withholding pyridostigmine for several days, the patient has moderate right lid ptosis and horizontal diplopia at rest. These resolved within 30 seconds after injection of 2 mg edrophonium (Tensilon) and recurred 60 seconds later.

Duration: 2:06

Associated with: CONTINUUM: Lifelong Learning in Neurology. 20(5):1413-1425, October 2014

Published on: 10.24.2014

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