J Mov Disord.  2019 Jan;12(1):1-13. 10.14802/jmd.18034.

Abnormal Eye Movements in Parkinsonism and Movement Disorders

Affiliations
  • 1Department of Neurology, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Korea.
  • 2Department of Neurology, Seoul National University College of Medicine, Seoul, Korea. jisookim@snu.ac.kr
  • 3Dizziness Center, Clinical Neuroscience Center, and Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.

Abstract

Abnormal eye movements are commonly observed in movement disorders. Ocular motility examination should include bedside evaluation and laboratory recording of ocular misalignment, involuntary eye movements, including nystagmus and saccadic intrusions/oscillations, triggered nystagmus, saccades, smooth pursuit (SP), and the vestibulo-ocular reflex. Patients with Parkinson's disease (PD) mostly show hypometric saccades, especially for the self-paced saccades, and impaired SP. Early vertical saccadic palsy is characteristic of progressive supranuclear palsy-Richardson's syndrome. Patients with cortico-basal syndrome typically show a delayed onset of saccades. Downbeat and gaze-evoked nystagmus and hypermetric saccades are characteristic ocular motor findings in ataxic disorders due to cerebellar dysfunction. In this review, we discuss various ocular motor findings in movement disorders, including PD and related disorders, ataxic syndromes, and hyperkinetic movement disorders. Systemic evaluation of the ocular motor functions may provide valuable information for early detection and monitoring of movement disorders, despite an overlap in the abnormal eye movements among different movement disorders.

Keyword

Eye movements; parkinsonism; ataxia; saccades

MeSH Terms

Ataxia
Cerebellar Diseases
Eye Movements*
Humans
Hyperkinesis
Movement Disorders*
Paralysis
Parkinson Disease
Parkinsonian Disorders*
Pursuit, Smooth
Reflex, Vestibulo-Ocular
Saccades
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