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Review Article
- Dizziness and neuro-otologic findings in neurodegenerative disorders: a review
- Seunghee Na, Yun Jeong Hong, Seong-Hoon Kim, Eek-Sung Lee
- Res Vestib Sci. 2025;24(2):68-78. Published online June 15, 2025
- DOI: https://doi.org/10.21790/rvs.2024.026
- 4,571 View
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Abstract
PDF - Eye movement abnormalities can provide valuable diagnostic insights across various neurodegenerative disorders. This review summarizes the characteristic oculomotor findings in different neurodegenerative conditions, focusing on cognitive disorders and parkinsonian syndromes. The neural control of eye movements involves complex networks across multiple cortical regions, including the frontal eye field, supplementary eye field, and dorsolateral prefrontal cortex, functioning in coordination with subcortical structures. In Alzheimer disease, patients exhibit impaired fixation with large saccadic intrusions, prolonged saccadic latency, and increased antisaccade errors, which correlate with cognitive decline. Frontotemporal dementia shows variant-specific patterns of oculomotor dysfunction, with behavioral variant particularly affecting antisaccade performance while maintaining the ability to self-correct errors. In parkinsonian syndromes, distinctive eye movement abnormalities aid in differential diagnosis. Idiopathic Parkinson disease typically presents with hypometric saccades and increased saccadic intrusions during fixation, which correlate with disease severity. Progressive supranuclear palsy characteristically shows early vertical saccade abnormalities and frequent macro–square-wave jerks. Multiple system atrophy demonstrates various central nystagmus patterns and perverted head-shaking nystagmus, while corticobasal degeneration presents with saccadic apraxia and asymmetric oculomotor abnormalities. While eye movement abnormalities can be nonspecific and overlap between conditions, careful evaluation of oculomotor function can provide important diagnostic clues, particularly for differentiating parkinsonian syndromes. Understanding these distinct patterns of oculomotor abnormalities provides critical insights into the underlying pathophysiology and serves as a valuable tool for differential diagnosis of neurodegenerative disorders.
Original Article
- Saccadic oscillations as a possible indicator of dizziness due to choline esterase inhibitors: an observational study with video-oculography
- Ileok Jung, Moon-Ho Park, Ji-Soo Kim
- Res Vestib Sci. 2024;23(3):101-105. Published online September 15, 2024
- DOI: https://doi.org/10.21790/rvs.2024.015
- 4,253 View
- 38 Download
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Abstract
PDF
Supplementary Material - Introduction: Cholinesterase inhibitors (ChEIs) are widely used to treat mild to moderate Alzheimer disease and vascular dementia. Even though dizziness due to medication of ChEIs has been ascribed to adverse effects on the cardiovascular or central nervous system, the mechanisms remain unclear and objective indicators are not available.
Methods
We recorded the eye movements using video-oculography in three patients who developed dizziness and unsteadiness after initiation or increment of ChEI, donepezil (Aricept).
Results
The patients showed frequent saccadic oscillations that improved after discontinuation of ChEI.
Conclusions
Frequent saccadic oscillations may be an indicator of dizziness in patients taking ChEIs.
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