The gait is wide-based and the patient requires assistance from the physician for stabilization. The patient cannot turn within one or two steps but requires multiple steps. The physician then asks the patient to perform tandem-walking at the end of the video but the patient is unable to do so due to severe instability. The…
The patients in these two photos show the classical signs of Horner’s syndrome. In the first photo (Figure 1), there is left-sided partial ptosis, miosis and anhidrosis. Whilst in the second photo (Figure 2), there is right-sided ptosis and miosis. Horner’s syndrome is caused by a lesion affecting the sympathetic pathway. This pathway starts as…
In the first video, the patient has both horizontal nystagmus and vertical “down-beat” nystagmus. In the second video, the patient has a torsional nystagmus when looking to her right hand side. Discussion of the sign Nystagmus is defined as a rhythmic oscillation of the eyes. It usually consists of a slow drifting phase in one direction and a…
In this patient, there is a mild esotropia on neutral gaze as the left eye is slightly deviated medially. There is impaired left eye abduction resulting in diplopia when the patient is instructed to look towards the left. Discussion of the sign Abduction of the eye is controlled by the lateral rectus muscle, which is…
This patient did not have any recent ocular symptoms but was noted to have significant right eye ophthalmoplegia during examination, whilst the left eye movements were completely normal. There was no double vision upon testing. Whilst one would need to consider a combined third, fourth and sixth nerve palsy in a patient with unilateral opthalmoplegia,…