By American Academy of Ophthalmology, Rod Foroozan MD
Presents a symptom-driven method of the analysis and therapy of significant neuro-ophthalmic stipulations. With the point of interest at the sufferer, this publication emphasizes exam and applicable adjunctive experiences, together with a dialogue of diagnostic imaging modalities, and leads the reader throughout the occasionally refined manifestations of neuro-ophthalmic sickness to anatomical localization of lesions and definitive analysis. an summary of the anatomy of visible pathways is observed via many illustrations.
Upon of entirety of part five, readers will be capable to:
- Describe a symptom-driven method of sufferers with universal neuro-ophthalmic court cases for you to formulate a suitable differential diagnosis
- pick out the main applicable checks and imaging, in line with symptomatology, to diagnose and deal with neuro-ophthalmic issues in an economical manner
- determine eye move problems and the ocular motor approach
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Additional info for 2014-2015 Basic and Clinical Science Course (BCSC): Section 5: Neuro-Ophthalmology
The MLF also receives interneurons originating from the contralateral CN VI nucleus. Additional vertical pathways include the brachium conjunctivum and the ascending tract of Deiters. The latter pathway runs lateral to the MLF and conveys signals from CN VIII nuclei ipsilaterally to the medial rectus subnucleus in the midbrain, modulating the vestibular response during near fixation. To maintain eccentric gaze, additional tonic input must be provided to the yoke muscles that hold the eye in position.
Each system appears to be under the control of-and modulated by-different regions of the brain (cortex) and brainstem, with considerable anatomical and functional overlap. This section provides an overview of the ocular motor system, with a detailed discussion of particularly clinically relevant structures. Interested readers can find a comprehensive description of the ocular motor system in the outstanding textbook by Leigh and Zee (Leigh RJ, Zee DS. The Neurology of Eye Movements. 4th ed. ) To facilitate learning, the discussion follows a top-to-bottom approach: 1at," proThe nior • cortical control of eye movements, including basal ganglia (BG), thalamus, and superior colliculus (SC) • brainstem or premotor coordination of conjugate eye movements, including the vestibular-ocular system and cerebellum • ocular motor cranial nerves ( CNs III, IV, and VI) • extraocular muscles (EOMs) Cortical Input The efferent visual system spans a large segment of the central nervous system, with many areas of the brain generating eye movements (Fig 1-23).
A large proximal branch of the AICA, the internal auditory artery, supplies the CN VIII complex in the subarachnoid space and follows it into the internal auditory canal. Along the course of the BA, small perforators arise directly to supply portions of the pons and midbrain. The median perforators of the BA supply the medial longitudinal fasciculus, the paramedian pontine formation, and the medially located nuclei of CNs III, IV, and VI. Interruption of these branches (which occurs commonly with vertebrobasilar atherosclerotic disease or emboli to these endarteries) often produces variable ophthalmoplegia, internuclear ophthalmoplegia, and skew deviation.
2014-2015 Basic and Clinical Science Course (BCSC): Section 5: Neuro-Ophthalmology by American Academy of Ophthalmology, Rod Foroozan MD