Eye movements in demyelinating, autoimmune and metabolic disorders

Jorge C. Kattah, David S. Zee

Research output: Contribution to journalReview articlepeer-review


Purpose of reviewIn the last three decades, the use of eye movements and vestibular testing in many neurological disorders has accelerated, primarily because of practical technologic developments. Although the acute vestibular syndrome is a prime example of this progress, more chronic neurologic and systemic disorders have received less attention. We focus here on recent contributions relating vestibular and ocular motor abnormalities in inflammatory, demyelinating, metabolic, and peripheral nervous system disordersRecent findingsVestibular abnormalities have been identified in acute demyelinating neuropathies (AIDP), in novel genetic mutations responsible for CANVAS (cerebellar ataxia, neuropathy vestibular areflexia syndrome), and in other inherited neuropathies (variants of Charcot-Marie-Tooth disease). In addition, there are differentiating characteristics between the most common CNS demyelinating disorders: Multiple sclerosis and neuromyelitis optica (NMO). We summarize new information on Vitamin D metabolism in benign paroxysmal positional vertigo (BPPV), followed by a brief review of the vestibular and ocular motor findings in Wernicke's encephalopathy. We conclude with findings in several paraneoplastic/autoimmune disorders.SummaryThis literature review highlights the impact of a careful vestibular and ocular motor evaluation in common neurologic disorder, not only for the initial diagnosis but also for monitoring disease and rehabilitation. A careful examination of eye movements and vestibular function, supplemented with new video techniques to quantify the findings, should be part of the standard neurologic examination.

Original languageEnglish (US)
Pages (from-to)111-116
Number of pages6
JournalCurrent opinion in neurology
Issue number1
StatePublished - Feb 1 2020


  • demyelinating diseases
  • metabolic disorders
  • ocular motor abnormalities
  • polyneuropathy
  • vestibular disorders

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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