Eye movement control and its disorders. 2013

Atchareeya Wiwatwongwana, and Christopher J Lyons
Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada; Division of Pediatric Ophthalmology and Strabismus, Department of Ophthalmology, Chiang Mai University, Chiang Mai, Thailand.

We review the supranuclear control centers and pathways leading to individual cranial nerve nuclei in the brainstem. We discuss horizontal and vertical gaze and their abnormalities, and review the cranial nerves which subserve eye movements, III, IV, VI, including their clinical testing. We highlight the sites at which these nerves are clinically affected, which often result in characteristic associated features with neurological localizing value. Differential diagnoses of cranial nerve palsies including Duane and Möbius syndromes are also described. Lastly, we discuss the nature of childhood neuromuscular junction disorders such as myasthenia gravis, as well as disorders of the muscle itself (chronic progressive external ophthalmoplegia (CPEO), thyroid orbitopathy).

UI MeSH Term Description Entries
D009468 Neuromuscular Diseases A general term encompassing lower MOTOR NEURON DISEASE; PERIPHERAL NERVOUS SYSTEM DISEASES; and certain MUSCULAR DISEASES. Manifestations include MUSCLE WEAKNESS; FASCICULATION; muscle ATROPHY; SPASM; MYOKYMIA; MUSCLE HYPERTONIA, myalgias, and MUSCLE HYPOTONIA. Amyotonia Congenita,Oppenheim Disease,Cramp-Fasciculation Syndrome,Fasciculation-Cramp Syndrome, Benign,Foley-Denny-Brown Syndrome,Oppenheim's Disease,Benign Fasciculation-Cramp Syndrome,Benign Fasciculation-Cramp Syndromes,Cramp Fasciculation Syndrome,Cramp-Fasciculation Syndromes,Fasciculation Cramp Syndrome, Benign,Fasciculation-Cramp Syndromes, Benign,Foley Denny Brown Syndrome,Neuromuscular Disease,Oppenheims Disease,Syndrome, Cramp-Fasciculation,Syndrome, Foley-Denny-Brown,Syndromes, Cramp-Fasciculation
D009802 Oculomotor Nerve The 3d cranial nerve. The oculomotor nerve sends motor fibers to the levator muscles of the eyelid and to the superior rectus, inferior rectus, and inferior oblique muscles of the eye. It also sends parasympathetic efferents (via the ciliary ganglion) to the muscles controlling pupillary constriction and accommodation. The motor fibers originate in the oculomotor nuclei of the midbrain. Cranial Nerve III,Third Cranial Nerve,Nerve III,Nervus Oculomotorius,Cranial Nerve IIIs,Cranial Nerve, Third,Cranial Nerves, Third,Nerve IIIs,Nerve, Oculomotor,Nerve, Third Cranial,Nerves, Oculomotor,Nerves, Third Cranial,Oculomotor Nerves,Oculomotorius, Nervus,Third Cranial Nerves
D001933 Brain Stem The part of the brain that connects the CEREBRAL HEMISPHERES with the SPINAL CORD. It consists of the MESENCEPHALON; PONS; and MEDULLA OBLONGATA. Brainstem,Truncus Cerebri,Brain Stems,Brainstems,Cerebri, Truncus,Cerebrus, Truncus,Truncus Cerebrus
D005133 Eye Movements Voluntary or reflex-controlled movements of the eye. Eye Movement,Movement, Eye,Movements, Eye
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015835 Ocular Motility Disorders Disorders that feature impairment of eye movements as a primary manifestation of disease. These conditions may be divided into infranuclear, nuclear, and supranuclear disorders. Diseases of the eye muscles or oculomotor cranial nerves (III, IV, and VI) are considered infranuclear. Nuclear disorders are caused by disease of the oculomotor, trochlear, or abducens nuclei in the BRAIN STEM. Supranuclear disorders are produced by dysfunction of higher order sensory and motor systems that control eye movements, including neural networks in the CEREBRAL CORTEX; BASAL GANGLIA; CEREBELLUM; and BRAIN STEM. Ocular torticollis refers to a head tilt that is caused by an ocular misalignment. Opsoclonus refers to rapid, conjugate oscillations of the eyes in multiple directions, which may occur as a parainfectious or paraneoplastic condition (e.g., OPSOCLONUS-MYOCLONUS SYNDROME). (Adams et al., Principles of Neurology, 6th ed, p240) Brown Syndrome,Brown Tendon Sheath Syndrome,Brown's Syndrome,Convergence Insufficiency,Eye Movement Disorders,Internuclear Ophthalmoplegia,Ocular Torticollis,Opsoclonus,Parinaud Syndrome,Skew Deviation,Smooth Pursuit Deficiency,Brown's Tendon Sheath Syndrome,Convergence Excess,Cyclophoria,Deficiency, Smooth Pursuit,Eye Motility Disorders,Parinaud's Syndrome,Paroxysmal Ocular Dyskinesia,Pseudoophthalmoplegia,Spasm of Conjugate Gaze,Syndrome, Brown's Tendon Sheath,Tendon Sheath Syndrome of Brown,Browns Syndrome,Conjugate Gaze Spasm,Conjugate Gaze Spasms,Convergence Excesses,Convergence Insufficiencies,Cyclophorias,Deficiencies, Smooth Pursuit,Deviation, Skew,Deviations, Skew,Dyskinesia, Paroxysmal Ocular,Dyskinesias, Paroxysmal Ocular,Excess, Convergence,Eye Motility Disorder,Eye Movement Disorder,Gaze Spasms, Conjugate,Insufficiencies, Convergence,Insufficiency, Convergence,Internuclear Ophthalmoplegias,Ocular Dyskinesia, Paroxysmal,Ocular Dyskinesias, Paroxysmal,Ocular Motility Disorder,Ophthalmoplegia, Internuclear,Ophthalmoplegias, Internuclear,Parinauds Syndrome,Paroxysmal Ocular Dyskinesias,Pseudoophthalmoplegias,Pursuit Deficiencies, Smooth,Pursuit Deficiency, Smooth,Skew Deviations,Smooth Pursuit Deficiencies,Syndrome, Brown,Syndrome, Brown's,Syndrome, Parinaud,Syndrome, Parinaud's

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