Tics/Stereotypies - Phenomenology Atlas

Tics/Stereotypies - Phenomenology Atlas

Video 9.1 (C9c1): Chronic Simple Motor Tics

Simple motor tics involving the face, jaw, arms, and legs with excellent long-term response to clonazepam.

Video 9.2 (C9c2): Mild Facial and Neck Tics

Subtle eyelid closure and neck tics managed conservatively without treatment.

Video 9.3 (C9c3): Chronic Motor Tic Disorder

Blinking, neck-turning, and facial tics with sustained benefit from clonazepam therapy.

Video 9.4 (C9c4): Simple Eyebrow-Raising Tic

Isolated forehead and eyebrow tics requiring no treatment.

Video 9.5 (C9c5): Forehead Tic in Childhood

Classic eyebrow-raising and forehead tics observed on home video.

Video 9.6 (C9c6): Complex Motor Tics

Facial, jaw, platysma, and repetitive touching behaviors responding well to clonazepam.

Video 9.7 (C9c7): Lower Cranial Motor Tics

Lip, jaw, and lower facial tics with excellent treatment response.

Video 9.8 (C9c8): Facial and Neck Tic Disorder

Simple motor tics affecting the face and neck with partial suppressibility.

Video 9.9 (C9c9): Complex Hand Tic

Repetitive hand movements across the face in an otherwise healthy child.

Video 9.10 (C9c10): Blinking and Nose-Wrinkling Tics

Mild facial motor tics not requiring treatment.

Video 9.11 (C9c11): Ear-Wiggling Complex Tic

Repetitive complex motor tic involving ear elevation.

Video 9.12 (C9c12): Complex Ocular Tic

Stereotyped blinking and sustained eye deviation occurring during relaxation.

Video 9.13 (C9c13): Ocular Tic Disorder

Eye deviation tics associated with a premonitory urge and relief after execution.

- Pending

Video 9.14 (C9c14): Limb Motor Tics

Occasional shoulder, arm, and finger tics without functional impairment.

Video 9.15 (C9c15): Childhood Ocular Tics

Intermittent eye deviation consistent with chronic simple motor tic disorder.

Video 9.16 (C9c16): Midline Motor Tic Syndrome

Blinking, sniffing, and repetitive abdominal contractions.

Video 9.17 (C9c17): Scapular Tic Disorder

Continuous scapular movements with audible popping and shoulder shrugging.

Video 9.18 (C9c18): Stair-Descending Complex Tic

Task-specific tic triggered only while descending stairs.

Video 9.19 (C9c19): Severe Complex Motor Tic Disorder

Compulsive writhing movements and dangerous forward-falling tics.

Video 9.20 (C9c20): Vocal Tic Disorder

Frequent forceful throat-clearing vocalizations resistant to clonazepam.

Video 9.21 (C9c21): Tourette Syndrome with Vocal Tics

Motor and vocal tics including blinking, shrugging, throat-clearing, and vocalizations.

Video 9.22 (C9c22): Facial Tic Disorder

Blinking, sniffing, and lower facial tics without vocal involvement.

Video 9.23 (C9c23): Severe Motor Tic Disorder

Prominent facial, neck, limb, and truncal tics with limited suppressibility.

Video 9.24 (C9c24): Motor Tics with Compulsive Behaviors

Facial tics accompanied by compulsive repetitive hand rubbing.

Video 9.25 (C9c25): Tourette Syndrome with Complex Tics

Continuous vocal and motor tics with multiple compulsive movements.

Video 9.26 (C9c26): Severe Tourette Syndrome

Complex motor and vocal tics including touching behaviors, vocalizations, and coprolalia.

Video 9.27 (C9c27): Tic Status

Near-continuous motor and respiratory tics with aerophagia and inability to suppress movements.

Video 9.28 (C9c28): Tourette Syndrome with Multiple Tic Phenotypes

Extensive simple and complex motor tics with vocal squeaking.

Video 9.29 (C9c29): Severe Tic Paroxysms

Explosive episodes of head-banging, shouting, and cursing superimposed on chronic tics.

Video 9.30 (C9c30): Advanced Tourette Syndrome

Facial, neck, axial, spitting, and cursing tics interfering with communication.

Video 9.31 (C9c31): Severe Tourette Tic Crisis

Unremitting motor and vocal tics with sustained retrocollis.

Video 9.32 (C9c32): Screaming Vocal Tics

Frequent screaming vocalizations occurring every 10 to 15 seconds.

Video 9.33 (C9c33): Tourette Syndrome with Functional Overlay

Groaning tics followed by distractible functional flailing movements.

Video 9.34 (C9c34): Autism with Stereotypies and Myoclonus

Hand-clapping stereotypies and task-induced multifocal myoclonic jerks.

Video 9.35 (C9c35): Autism with Complex Stereotypies

Rocking, hand waving, clapping, and repetitive self-directed behaviors.

Video 9.36 (C9c36): Stereotypy Responsive to Tetrabenazine

Repetitive dystonic posturing successfully treated with long-term tetrabenazine.

Video 9.37 (C9c37): Tetrabenazine-Induced Oculogyric Crisis

Autism-associated stereotypies complicated by drug-induced dystonic eye deviation episodes.

Video 9.38 (C9c38): Autism-Related Stereotypies

Hand flapping, arm posturing, and repetitive face-touching improved with clonazepam.

Video 9.39 (C9c39): Stereotypies with Freezing Episodes

Repetitive hand movements and staring associated with negative motor phenomena.

Video 9.40 (C9c40): Complex Stereotypy Syndrome

Episodes of repetitive hand, facial, vocal, and truncal movements responsive to valbenazine.

Video 9.41 (C9c41): Rett Syndrome with Stereotypies

Hand wringing, hand flapping, myoclonus, and episodic eye deviation with breath holding.

Video 9.42 (C9c42): Rett Syndrome with Ataxia and Negative Myoclonus

Hand-clapping stereotypies, truncal ataxia, and standing-induced negative myoclonus.

Video 9.43 (C9c43): Childhood Complex Stereotypies

Hand twirling, arm posturing, and repetitive flapping behaviors.

Video 9.44 (C9c44): Suppressible Hand-Twirling Stereotypies

Frequent bilateral hand-twirling movements reduced by distraction.

Video 9.45 (C9c45): Childhood Motor Stereotypies

Arm flailing, rocking, and kicking movements in an otherwise interactive child.

Video 9.46 (C9c46): Video Game-Induced Finger Stereotypies

Repetitive stereotyped finger flexion triggered by focused gameplay.

Video 9.47 (C9c47): Toddler Stereotypies During Concentration

Highly stereotyped repetitive movements occurring during focused activities.

Video 9.48 (C9c48): “Hercules Pose” Stereotypy

Sustained, repetitive flexion and extension posturing of the arms.

Video 9.49 (C9c49): Head-Rocking Stereotypy

Repetitive head rocking during musical performance without awareness.

Video 9.50 (C9c50): Hand-Writhing Stereotypy

Frequent stereotyped writhing hand movements without functional impairment.

Other Tremors - Phenomenology Atlas

Other Tremors - Phenomenology Atlas

Video 8.1 (C8c1): Orthostatic Tremor with Sensory Trick

Subjective unsteadiness while standing that improved immediately with light touch to the examiner or a wall, with relatively preserved gait.

Video 8.2 (C8c2): Classic Orthostatic Tremor

Rapid leg tremor and subjective shakiness developing within seconds of standing, relieved by walking.

Video 8.3 (C8c3): Orthostatic Tremor with Mild Action Tremor

Fine high-frequency leg tremor triggered by standing and accompanied by mild upper-limb action tremor.

Video 8.4 (C8c4): Orthostatic Tremor Responsive to Touch

Severe standing instability relieved by touching a wall or another person despite minimal visible tremor.

Video 8.5 (C8c5): Orthostatic Tremor with Essential Tremor and Primary Writing Tremor

Coexisting orthostatic tremor, essential tremor, and primary writing tremor with preserved walking.

Video 8.6 (C8c6): Severe Orthostatic Tremor

Progressive shakiness on standing causing inability to remain upright, with normal walking.

Video 8.7 (C8c7): Orthostatic Tremor in Parkinsonism

Standing-triggered tremor relieved by light touch, with preserved gait despite mild parkinsonian features.

Video 8.8 (C8c8): Orthostatic Tremor Improved with Clonazepam

Marked standing-induced tremor and imbalance with significant improvement following clonazepam therapy.

Video 8.9 (C8c9): Orthostatic Tremor Improved with Levetiracetam

Subjective leg weakness and truncal sway while standing, relieved by light touch and improved with levetiracetam.

Video 8.10 (C8c10): Orthostatic Tremor with Falls on Standing

Progressive leg tremor causing loss of balance during standing, responsive to levetiracetam.

Video 8.11 (C8c11): Advanced Orthostatic Tremor

Immediate standing tremor with compensatory wide stance and marked instability during tandem position.

Video 8.12 (C8c12): Orthostatic Tremor with Severe Gait Fearfulness

Visible leg tremor and marked unsteadiness on standing, relieved by touching another person.

Video 8.13 (C8c13): Severe Orthostatic Tremor with Anxiety

Profound standing-induced wobbliness improved by touching walls or another person for support.

Video 8.14 (C8c14): Enhanced Physiologic Tremor from Hyperthyroidism

Fine symmetric postural and kinetic tremor associated with tachycardia, exophthalmos, and thyroid enlargement.

Video 8.15 (C8c15): Hyperthyroid Tremor

Fine bilateral high-frequency postural and kinetic tremor with diffuse goiter and otherwise normal neurologic examination.

Video 8.16 (C8c16): Dystonic Head Tremor with Sensory Tricks

Jerky multidirectional neck tremor relieved by chin touch or head contact with a surface.

Video 8.17 (C8c17): Cervical Dystonia with Dystonic Tremor

Irregular neck tremor associated with torticollis and laterocollis, improved by head support.

Video 8.18 (C8c18): DYT1 Dystonia with Dystonic Tremor

Jerky dystonic upper-limb movements and tremor activated by posture and relieved by repositioning.

Video 8.19 (C8c19): Parkinsonian Tremor Spectrum

Examples of classic resting tremor in Parkinson's disease affecting the hands and leg, with re-emergence after repositioning.

Video 8.20 (C8c20): Cerebellar (Holmes) Tremor after Midbrain Lesion

Low-frequency proximal tremor present at rest, posture, and action, worsening during target-directed movements.

Video 8.21 (C8c21): Bilateral Cerebellar Tremor

Coarse proximal tremor with dysmetria, intention worsening, and mild gait ataxia.

Video 8.22 (C8c22): Cerebellar Tremor after Midbrain Hemorrhage

Unilateral proximal tremor affecting arm and leg, associated with hemiparetic gait and impaired dexterity.

Video 8.23 (C8c23): Cerebellar Tremor with Titubation and Oscillopsia

Severe head tremor causing oscillopsia accompanied by prominent proximal arm tremor.

Video 8.24 (C8c24): Valproate (Depakote)-Induced Tremor

Fine fast bilateral postural and kinetic tremor without parkinsonism.

Video 8.25 (C8c25): Mild Valproate-Induced Tremor

Subtle kinetic tremor with preserved gait and only mild tandem gait difficulty.

Video 8.26 (C8c26): Parkinson's Disease Worsened by Risperidone

Severe parkinsonism with facial masking, resting tremor, bradykinesia, and rigidity.

Video 8.27 (C8c27): Tremor Phenotypes in Wilson's Disease

Examples of wing-beating tremor, dystonic tremor, parkinsonism, generalized dystonia, and risus sardonicus.

Video 8.28 (C8c28): Functional Tremor

Variable, irregular tremor affecting the limbs with preserved coordination and persistence during complex gait tasks.

Essential Tremor - Phenomenology Atlas

Essential Tremor - Phenomenology Atlas

Video 7.1 (C7c1): Classic Essential Tremor

Mild head and voice tremor with postural and kinetic hand tremor affecting finger-to-nose testing, pouring, and targeting tasks.

Video 7.2 (C7c2): Mild Essential Tremor

Subtle vocal tremor with mild postural tremor and moderate action tremor during spiral drawing and pouring.

Video 7.3 (C7c3): Asymmetric Essential Tremor

Mild vocal tremor with severe right-hand action tremor causing marked impairment of writing and utensil use.

Video 7.4 (C7c5): Essential Tremor with Voice Tremor

Moderate vocal tremor, bilateral postural and kinetic tremor, and difficulty with tandem gait.

Video 7.5 (C7c6): Essential Tremor with Jaw Tremor

Prominent jaw tremor, moderate voice tremor, and mild postural and kinetic arm tremor.

Video 7.6 (C7c7): Isolated Vocal Tremor

Prominent 4 Hz voice tremor with only minimal limb tremor.

Video 7.7 (C7c8): Severe Vocal and Head Tremor

Marked voice and head tremor with visible laryngeal oscillation and moderate upper-limb action tremor.

Video 7.8 (C7c9): Essential Tremor with Head and Voice Involvement

Moderate vocal and no-no head tremor accompanied by prominent postural and kinetic hand tremor.

Video 7.9 (C7c10): Severe Upper Limb Essential Tremor

Markedly disabling postural and action tremor, worse in the dominant hand, preventing writing.

Video 7.10 (C7c11): Essential Tremor with Rest Tremor

Rest, postural, and kinetic tremor with visual feedback dependence and impaired tandem gait.

Video 7.11 (C7c12): Severe Essential Tremor after DBS Adjustment

Coarse bilateral postural and action tremor with severe functional impairment and asymmetric stimulation effects.

Video 7.12 (C7c13): Advanced Essential Tremor

Severe bilateral action tremor causing inability to write, draw spirals, or pour liquids.

Video 7.13 (C7c14): Mild Essential Voice Tremor

Tremor limited predominantly to sustained phonation and singing.

Video 7.14 (C7c15): Isolated Essential Voice Tremor

Prominent pharyngeal and laryngeal tremor without limb involvement.

Video 7.15 (C7c16): Severe Isolated Vocal Tremor

Marked pharyngeal and laryngeal tremor affecting speech and sustained phonation.

Video 7.16 (C7c17): Isolated Head Tremor

Mild no-no head tremor without voice or limb tremor.

Video 7.17 (C7c18): Severe Isolated Head Tremor

Prominent no-no head tremor with minimal limb tremor.

Video 7.18 (C7c19): Head and Voice Tremor Syndrome

Combined no-no head tremor and voice tremor without upper-limb involvement.

Video 7.19 (C7c20): Essential Voice Tremor with Mild Head Tremor

Prominent vocal tremor causing speech interruptions with minimal head tremor.

Video 7.20 (C7c21): Cranial Essential Tremor

Voice, palate, pharyngeal, laryngeal, and head tremor without limb tremor.

Video 7.21 (C7c22): Severe Vocal Tremor with Jaw Involvement

Vocal tremor causing voice breaks with only minimal kinetic limb tremor.

Video 7.22 (C7c23): Unilateral Essential Tremor

Position-specific left-hand tremor with writing difficulty, mirror tremor, and mild voice tremor.

Video 7.23 (C7c24): Primary Writing Tremor with Mirror Tremor

Task-specific right-hand tremor during writing and targeting tasks with mirror tremor of the opposite hand.

-Pending

Video 7.24 (C7c25): Isolated Primary Writing Tremor

Regular oscillatory tremor occurring exclusively during writing.

Video 7.25 (C7c26): Primary Writing Tremor

Task-specific wrist tremor triggered by pen use and writing, absent during other activities.

Video 7.26 (C7c27): Primary Writing Tremor with Vertical Writing

Writing-induced tremor present on paper and wall-writing tasks.

Video 7.27 (C7c28): Primary Writing Tremor with Mirror Movements

Writing-triggered tremor and contralateral mirror tremor without other tremor manifestations.

Video 7.28 (C7c29): Task-Specific Writing Tremor

Writing-induced tremor with contralateral mirror tremor and no spiral tremor.

Video 7.29 (C7c30): Primary Writing Tremor with Coexisting ET

Writing tremor associated with characteristic essential tremor spiral and mirror tremor.

Video 7.30 (C7c31): Task-Specific Occupational Tremor (Dentist)

Occupation-related tremor triggered only during dental working postures.

Video 7.31 (C7c32): Task-Specific Tremor Responsive to Botulinum Toxin

Position-dependent pronation-supination tremor improved with targeted botulinum toxin injections.

Video 7.32 (C7c33): Musician's Tremor (Violin Bow Arm)

Task-specific wrist tremor triggered only while holding and using a violin bow.

Video 7.33 (C7c34): Violinist's Bowing Tremor

Position-specific bow-arm tremor reproduced by simulated instrument posture.

Video 7.34 (C7c35): Severe Violinist's Tremor

Task-specific bowing tremor impairing sound production and improved by muscle stabilization.

Video 7.35 (C7c36): Bowing Tremor in Violin Performance

Arm tremor occurring only during active violin playing.

Video 7.36 (C7c37): Musician's Tremor with Mild Essential Tremor

Task-specific bow-arm tremor superimposed on mild essential tremor.

Video 7.37 (C7c38): String Instrument Bowing Tremor

Tremor triggered specifically when bow contacts the string, partially responsive to botulinum toxin.

Video 7.38 (C7c39): Musician's Tremor of the Fingering Hand

Task-specific tremor affecting left-hand finger positioning during performance.

Video 7.39 (C7c40): Primary Writing Tremor Progressing to Essential Tremor

Longstanding writing tremor later accompanied by rest, kinetic, and spiral tremor typical of ET.

Video 7.40 (C7c41): Primary Writing Tremor with Essential Tremor Features

Writing tremor associated with mild voice, rest, postural, and kinetic tremor.

Video 7.41 (C7c42): Primary Writing Tremor and Essential Tremor

Classic writing tremor occurring alongside bilateral action tremor and ET spirals.

Video 7.42 (C7c43): Severe Primary Writing Tremor with ET

Task-specific writing tremor with profound tremor during spiral drawing but absent finger-to-nose tremor.

Video 7.43 (C7c44): Essential Voice Tremor Responsive to Primidone

Moderate voice tremor with improvement after primidone treatment.

Video 7.44 (C7c45): Essential Voice Tremor Responsive to Sodium Oxybate

Isolated vocal tremor showing marked short-term improvement after sodium oxybate.

Video 7.45 (C7c46): Chronic Vocal Tremor Treated with Sodium Oxybate

Prominent voice tremor with sustained long-term benefit from sodium oxybate.

Video 7.46 (C7c47): Voice and Head Tremor Responsive to Sodium Oxybate

Moderately severe vocal and head tremor improving after sodium oxybate administration.

Video 7.47 (C7c48): Essential Tremor Responsive to Sodium Oxybate

Severe upper-limb action tremor markedly improved after sodium oxybate treatment.

Video 7.48 (C7c49): Musician's Tremor Treated with Botulinum Toxin

Instrument-specific finger tremor improved following ultrasound-guided botulinum toxin injections.

Video 7.49 (C7c50): Task-Specific Tremor Treated with Botulinum Toxin

Examples of essential and task-specific tremors showing functional improvement after targeted injections.

Video 7.50 (C7c51): Essential Tremor Treated with Focused Ultrasound Thalamotomy

Severe medically refractory tremor with marked post-procedural improvement following Vim HIFU thalamotomy.

Corticobasal Syndrome (CBS) - Phenomenology Atlas

Corticobasal Syndrome (CBS) - Phenomenology Atlas

Video 6.1 (C6c1): Corticobasal Syndrome with Cortical Sensory Loss

Left-hand action myoclonus, impaired graphesthesia and stereognosis, and focal right perirolandic cortical atrophy.

Video 6.2 (C6c2): Corticobasal Syndrome with Limb Apraxia

Loss of proprioceptive control and impaired individuated finger movements of the left hand with reduced arm swing.

Video 6.3 (C6c3): Corticobasal Syndrome with Ideomotor Apraxia

Left-hand dexterity impairment, body-part-as-object substitution, and progressive hemispatial neglect.

Video 6.4 (C6c7): Corticobasal Syndrome with Apraxia and Cognitive Dysfunction

Ideomotor apraxia, impaired dexterity, head-thrust saccades, reduced arm swing, and inability to copy pentagons.

Video 6.5 (C6c12): Corticobasal Syndrome with Cortical Myoclonus

Left-arm myoclonus, athetosis, rigidity, cortical sensory loss, and stimulus-sensitive cortical reflex myoclonus.

Video 6.6 (C6c16): Advanced Corticobasal Syndrome

Continuous left-arm myoclonus, severe limb apraxia, rigidity, cortical sensory deficits, and gait impairment.

Video 6.7 (C6c17): Corticobasal Syndrome with Dystonic Pistol-Grip Hand

Severe right-arm rigidity, dystonic hand posturing, gait hesitation, and asymmetric parkinsonism.

Video 6.8 (C6c18): Cortical Reflex Myoclonus

Action- and position-induced myoclonus with stimulus-sensitive cortical reflex myoclonus and preserved parkinsonism-free examination.

Video 6.9 (C6c20): Corticobasal Syndrome with Fixed Limb Dystonia

Severe right-arm dystonia, apraxia, absent arm swing, and preserved gait.

Video 6.10 (C6c21): Corticobasal Syndrome with Cortical Sensory Loss

Marked right-sided rigidity, impaired stereognosis, foot dystonia, and severe gait dysfunction.

Video 6.11 (C6c22): Asymmetric Corticobasal Syndrome

Profound right-hand bradykinesia and loss of individuated finger movements with preserved language and sensation.

Video 6.12 (C6c23): Corticobasal Syndrome with Severe Limb Apraxia

Left-arm dystonia, ideomotor apraxia, rigidity, and marked gait impairment.

Video 6.13 (C6c24): Corticobasal Syndrome with Myoclonic Tremor

Asymmetric parkinsonism, action-induced myoclonus mimicking tremor, and prominent apraxia.

Video 6.14 (C6c25): Corticobasal Syndrome with Alien Limb Features

Severe left-limb apraxia, cortical sensory loss, involuntary limb elevation, and gait dysfunction.

Video 6.15 (C6c28): Corticobasal Syndrome with Hemispatial Neglect

Profound left-hand dysfunction, astereognosis, visuospatial neglect, and evolution toward alien limb syndrome.

Video 6.16 (C6c29): Corticobasal Syndrome with Mirror Movements

Bilateral cortical reflex myoclonus, oculomotor apraxia, severe left-arm apraxia, and mirror movements.

Video 6.17 (C6c30): Behavioral-Speech Variant Tauopathy

Aprosodic speech, mild asymmetric parkinsonism, emotional indifference, and frontotemporal metabolic deficits.

Video 6.18 (C6c32): Primary Progressive Aprosodia

Markedly abnormal speech prosody with minimal parkinsonian findings and preserved gait.

Video 6.19 (C6c33): Tauopathy Speech Syndrome

Isolated motoric, aprosodic speech with otherwise normal neurological examination.

Video 6.20 (C6c34): Progressive Aprosodic Speech Disorder

Severely impaired speech prosody with minimal bradykinesia and preserved mobility.

Video 6.21 (C6c35): Nonfluent Primary Progressive Aphasia with Parkinsonism

Aprosodic speech, word-finding difficulty, mild asymmetric parkinsonism, and left frontotemporal atrophy.

Video 6.22 (C6c36): Progressive Aphasia Syndrome

Expressive-receptive aphasia with paraphasic errors, preserved reading, and mild bradykinesia.

Video 6.23 (C6c37): Nonfluent Aphasia with Asymmetric Parkinsonism

Halting speech, impaired speech repetition, left-hand motor impairment, and preserved comprehension.

Video 6.24 (C6c38): Parkinsonian Nonfluent Aphasia

Limited speech output, rigidity, bradykinesia, and mild gait impairment without apraxia.

Video 6.25 (C6c39): Severe Nonfluent Primary Progressive Aphasia

Single-syllable perseverative speech, inability to repeat, preserved calculation ability, and normal gait.

Video 6.26 (C6c40): Aphasia with Apraxia and Asymmetric Parkinsonism

Language impairment, inability to imitate learned actions, right-sided rigidity, and dystonic hand posturing.

Video 6.27 (C6c41): Progressive Apraxia Syndrome

Severe bilateral limb apraxia and agraphia with preserved speech, gait, and strength.

Video 6.28 (C6c42): Isolated Ideomotor Apraxia Syndrome

Profound bilateral hand apraxia with normal language, cognition, gait, and postural control.

Multiple System Atrophy (MSA) - Phenomenology Atlas

Multiple System Atrophy (MSA) - Phenomenology Atlas

Video 5.1 (C5c3): OPCA with Cerebellar Ataxia

Mild scanning dysarthria, ocular dysmetria, appendicular incoordination, and wide-based gait with MRI evidence of olivopontocerebellar atrophy.

Video 5.2 (C5c4): OPCA with Mild Autonomic Involvement

Scanning speech, appendicular dysmetria, and moderately wide-based gait consistent with olivopontocerebellar atrophy.

Video 5.3 (C5c6): OPCA with Ocular Dysmetria

Scanning speech, end-gaze nystagmus, ocular dysmetria, limb dysmetria, and mild gait ataxia with vermian cerebellar atrophy.

-No Video

Video 5.4 (C5c7): MSA with Parkinsonian and Cerebellar Features

Symmetric parkinsonism, wide-based stance, severe gait impairment, and preserved saccadic eye movements.

-No Video

Video 5.5 (C5c9): Cerebellar-Predominant MSA

Severe dysarthria, prominent square wave jerks, marked limb dysmetria, and unstable wide-based gait requiring a walker.

Video 5.6 (C5c12): Mild Cerebellar MSA

Mild dysarthria, subtle cerebellar signs, preserved ocular movements, and mildly wide-based gait.

Video 5.7 (C5c16): Mixed Parkinsonian-Cerebellar MSA

Facial masking, symmetric bradykinesia, ocular dysmetria, gait freezing, and postural instability.

Video 5.8 (C5c17): MSA with Diplophonia

Symmetric parkinsonism accompanied by diplophonia, dysmetria, freezing on turning, and impaired balance.

Video 5.9 (C5c18): Parkinsonian-Predominant MSA

Moderately severe symmetric parkinsonism with diplophonia, preserved eye movements, and stooped gait.

Video 5.10 (C5c19): MSA with Parkinsonism and Cerebellar Dysfunction

Hypophonia, dysarthria, ocular dysmetria, bradykinesia, limb incoordination, and unsteady parkinsonian gait.

Video 5.11 (C5c20): MSA with Hot-Cross-Bun Sign

Asymmetric parkinsonism, wide-based gait, imbalance, and MRI evidence of cerebellar and pontine atrophy.

Video 5.12 (C5c22): MSA with Anterocollis

Parkinsonism associated with progressive anterocollis, hypophonia, and reduced arm swing.

Video 5.13 (C5c23): MSA with Severe Anterocollis

Moderate symmetric parkinsonism and marked chin-on-chest posture despite preserved neck extensor strength.

Video 5.14 (C5c28): MSA with Nocturnal Stridor

Parkinsonism with truncal lean and life-threatening nocturnal stridor preceding respiratory decline.

Video 5.15 (C5c30): MSA with Inspiratory Stridor

Severe inspiratory stridor improved after tracheostomy, with only mild residual parkinsonism.

Video 5.16 (C5c31): Acute Stridor in MSA

Marked inspiratory stridor with minimal parkinsonian signs requiring urgent tracheostomy.

Video 5.17 (C5c33): Advanced MSA with Pisa Syndrome

Dysarthria, diplophonia, atremulous parkinsonism, truncal tilt, and characteristic hot-cross-bun MRI sign.

Video 5.18 (C5c34): MSA with Parkinsonism and Ataxia

Scanning dysarthria, diplophonia, severe bradykinesia, appendicular dysmetria, truncal tilt, and micrographia.

Video 5.19 (C5c35): Advanced Mixed-Phenotype MSA

Severe parkinsonism, rigidity, square wave jerks, cerebellar dysmetria, and profound gait dependence.

Video 5.20 (C5c39): Pathologically Confirmed MSA

Asymmetric bradykinesia with preserved gait and prominent macrosaccadic oscillations; autopsy confirmed multiple system atrophy.

Video 5.21 (C5c40): MSA with Levodopa-Induced Dyskinesias

Asymmetric parkinsonism responsive to levodopa, with prominent on-state dyskinesias and later pathological confirmation of MSA.

Progressive Supranuclear Palsy (PSP) - Phenomenology Atlas

Progressive Supranuclear Palsy (PSP) - Phenomenology Atlas

Video 4.1 (C4c2): Early PSP with Freezing of Gait

Mild vertical saccadic slowing, impaired vertical OKNs, significant freezing on turning, and impaired postural reflexes.

Video 4.2 (C4c3): Early PSP-Richardson Syndrome

Rare square wave jerks, round-the-house vertical saccades, abnormal vertical OKNs, and otherwise preserved gait and appendicular function.

Video 4.3 (C4c4): PSP with Freezing and Postural Instability

Vertical gaze impairment, square wave jerks, severe freezing on turning, and failure to recover on pull test.

Video 4.4 (C4c5): PSP with Gunslinger's Gait

Quizzical stare, prominent square wave jerks, vertical supranuclear signs, gunslinger's posture, and impaired balance.

Video 4.5 (C4c6): PSP with Vertical Gaze Palsy

Frequent square wave jerks, clear vertical supranuclear gaze defect, absent vertical OKN quick phases, and applause sign.

Video 4.6 (C4c7): PSP with Mild Gait Impairment

Facial masking, dysarthria, slowing of vertical saccades, impaired vertical OKNs, and relatively preserved balance.

Video 4.7 (C4c8): Mild PSP

Square wave jerks, round-the-house saccades, vertical gaze slowing, and preserved gait.

Video 4.8 (C4c9): PSP with Quizzical Stare

Mild parkinsonism, frequent square wave jerks, vertical saccadic slowing, and slow but stable gait.

Video 4.9 (C4c10): Early PSP with Gunslinger's Gait

Square wave jerks, mild vertical gaze slowing, and arm abduction while walking.

Video 4.10 (C4c11): PSP with Freezing of Gait

Vertical supranuclear gaze palsy, hypophonic scanning speech, freezing on turning, and impaired postural stability.

Video 4.11 (C4c14): Advanced PSP-Richardson Syndrome

Moderate vertical saccadic slowing, appendicular parkinsonism, severe gait instability, and freezing.

Video 4.12 (C4c15): PSP with Tectal Atrophy

Prominent square wave jerks, round-the-house vertical saccades, and slow walker gait with MRI evidence of tectal thinning.

Video 4.13 (C4c16): Advanced PSP with Dysarthria

Severe parkinsonism, absent downgaze, broad-based gait, and prominent gunslinger's posture.

Video 4.14 (C4c17): PSP with Gait Failure

Square wave jerks, vertical gaze impairment, preserved hand movements, and severe gait dysfunction requiring a walker.

Video 4.15 (C4c18): PSP with Marked Vertical Gaze Palsy

Prominent quizzical stare, severe vertical gaze limitation, absent vertical OKNs, and gunslinger's gait.

Video 4.16 (C4c19): PSP with Dysarthria and Imbalance

Severe dysarthria, square wave jerks, impaired vertical eye movements, applause sign, and impulsive unsteady gait.

Video 4.17 (C4c20): PSP with Strained Speech

Vertical supranuclear gaze palsy, square wave jerks, strained dysarthric speech, and preserved arm swing.

Video 4.18 (C4c21): PSP with Eyelid Opening Apraxia

Eyelid opening apraxia, round-the-house saccades, mild appendicular parkinsonism, and poor pull-test recovery.

Video 4.19 (C4c22): Advanced PSP with Eyelid Opening Apraxia

Profound parkinsonism, severe eyelid opening apraxia, freezing of gait, applause sign, and absent recovery on pull test.

Video 4.20 (C4c23): Advanced PSP with Near-Absent Vertical Saccades

Strangled dysarthric speech, eyelid opening apraxia, severe vertical gaze palsy, and marked postural instability.

Video 4.21 (C4c24): PSP with Facial Dystonia

Marked vertical gaze paresis, facial dystonia, dysarthria, and relatively mild appendicular slowing.

Video 4.22 (C4c25): Advanced PSP with Blepharospasm

Marked vertical gaze palsy, eyelid opening apraxia, blepharospasm, retropulsion, and moderate appendicular bradykinesia.

Video 4.23 (C4c26): PSP with Severe Balance Failure

Profound vertical saccadic defect, spastic dysarthria, inattention, applause sign, and severe postural instability.

Video 4.24 (C4c27): PSP with Emotional Incontinence

Vertical supranuclear gaze palsy, emotional incontinence, severe balance impairment, and difficulty arising.

Video 4.25 (C4c28): PSP with Tectal Thinning

Hypophonic strained speech, marked vertical saccadic impairment, slowed limb movements, and gait requiring assistance.

Video 4.26 (C4c29): Wheelchair-Bound Advanced PSP

Profound vertical gaze palsy, spastic dysarthria, applause sign, severe retropulsion, and dependence for ambulation.

Video 4.27 (C4c31): PSP with Marked Turning Freezing

Mild vertical saccadic slowing, preserved stride, and severe freezing during turning.

Video 4.28 (C4c32): Pathologically Confirmed Early PSP

Mild facial dystonia, subtle vertical gaze slowing, mild bradykinesia, and preserved gait early in the disease course.

Video 4.29 (C4c33): PSP with Isolated Ocular Signs

Marked supranuclear vertical gaze deficit, square wave jerks, gunslinger's gait, and minimal limb parkinsonism.

Video 4.30 (C4c34): PSP with Facial Dystonia

Quizzical stare, facial dystonia, mild vertical gaze limitation, and preserved gait.

Video 4.31 (C4c35): PSP with Cognitive Dysfunction

Micrographia, impaired visuospatial function, vertical gaze impairment, and abnormal pull test with mild limb bradykinesia.

Video 4.32 (C4c36): Very Early PSP

Subtle quizzical stare, mild vertical saccadic slowing, minimal limb involvement, and preserved gait.

Video 4.33 (C4c37): PSP with MRI Tectal Thinning

Marked slowing of vertical saccades, absent vertical OKNs, positive pull test, and characteristic tectal atrophy.

Video 4.34 (C4c38): Mild PSP with Ocular Motor Abnormalities

Mild dysarthria, infrequent square wave jerks, and vertical gaze slowing with impaired vertical OKNs.

Video 4.35 (C4c40): PSP with Macrosaccadic Oscillations

Moderate parkinsonism, prominent square wave jerks, macrosaccadic oscillations, severe vertical gaze palsy, and leg rest tremor.

Other Parkinsonisms - Phenomenology Atlas

Other Parkinsonisms - Phenomenology Atlas

Video 3.1 (C3c1): Chemotherapy-Induced Parkinsonism

Profound akinetic-rigid parkinsonism following intrathecal methotrexate and cytarabine, with inability to move, speak, or swallow. Marked improvement occurred with levodopa therapy.

Video 3.2 (C3c2): Gemcitabine-Induced Parkinsonism

Subacute symmetric parkinsonism developing after gemcitabine treatment, characterized by gait impairment, hand posturing, and bradykinesia, which resolved after levodopa treatment and drug withdrawal.

Video 3.3 (C3c3): Drug-Induced Parkinsonism Unmasking PD

Bilateral rest tremor, bradykinesia, cogwheel rigidity, and postural tremor related to chlorpromazine exposure, later revealed underlying Parkinson's disease.

Video 3.4 (C3c4): Risperidone-Induced Worsening of PD

Marked deterioration of established Parkinson's disease with worsening tremor, rigidity, drooling, and gait after risperidone initiation.

Video 3.5 (C3c5): Aripiprazole-Induced Parkinsonism

Mild asymmetric parkinsonism associated with aripiprazole exposure, followed by progression consistent with underlying Parkinson's disease.

Video 3.6 (C3c6): Drug-Induced Tremulous Parkinsonism

Prominent bilateral resting tremor with mild asymmetric bradykinesia and preserved gait.

Video 3.7 (C3c7): Mild Drug-Induced Parkinsonism

Subtle parkinsonian features including mild rest tremor, left-sided bradykinesia, and reduced arm swing.

Video 3.8 (C3c8): Drug-Induced Parkinsonism with Tardive Features

Classic parkinsonian rest tremor with mild asymmetric bradykinesia, rigidity, and associated chewing dyskinesia.

Video 3.9 (C3c9): Osmotic Myelinolysis-Induced Parkinsonism

Mixed parkinsonism and dystonia with facial dystonia, dysarthria, and dramatic dopaminergic responsiveness.

Video 3.10 (C3c10): Osmotic Demyelination Syndrome with Dystonia

Bilateral bradykinesia accompanied by foot dystonia that improved during walking.

Video 3.11 (C3c11): Postanoxic Parkinsonism

Symmetric parkinsonism with hypophonia, rigidity, bradykinesia, severe freezing of gait, and impaired postural reflexes.

Video 3.12 (C3c12): PSP-Like Syndrome Following Aortic Surgery

Severe supranuclear gaze palsy, facial masking, dysarthria, and palilalia with only mild appendicular parkinsonism.

Video 3.13 (C3c13): Mitochondrial Injury-Induced Parkinsonism

Severe parkinsonism with jaw-opening dystonia, marked bradykinesia, absent arm swing, toe walking, and postural instability.

Video 3.14 (C3c14): Structural Hemiparkinsonism-Hemidystonia

Unilateral parkinsonian rest tremor with dystonic hand posturing and striatal toe.

Video 3.15 (C3c15): True Vascular Parkinsonism

Right-sided parkinsonism associated with ipsilateral third nerve palsy, featuring classic pill-rolling tremor and mild rigidity.

Video 3.16 (C3c16): Dorsal Midbrain Syndrome with Parkinsonism

Parkinsonism associated with shunt over-drainage, characterized by vertical gaze impairment, facial masking, and mild asymmetric bradykinesia.

Video 3.17 (C3c17): Parkinsonism-Hyperpyrexia Syndrome

Severe rigidity and myoclonus following interruption of dopaminergic therapy, with subsequent recovery.

Video 3.18 (C3c18): Lower-Body Parkinsonism

Predominant lower-extremity bradykinesia with hypophonia, abulia, severe freezing of gait, and spontaneous retropulsion.

Video 3.19 (C3c19): Severe Lower-Body Parkinsonism

Normal upper-body examination with profound postural instability, inability to stand independently, and severe retropulsion.

Video 3.20 (C3c20): Unilateral Freezing of Gait (Right Leg)

Isolated freezing of the right leg during walking, improving with visual and rhythmic cueing strategies.

Video 3.21 (C3c21): Unilateral Freezing of Gait (Left Leg)

Freezing of the left leg during gait with marked improvement during backward walking, running, and stepping over obstacles.

Video 3.22 (C3c22): Postanoxic Parkinsonism with Akinetic Mutism

Profound bradyphrenia, hypophonia, akinetic mutism, and severe impairment of voluntary movement despite preserved cognition.

Video 3.23 (C3c23): Abulia

Marked loss of initiative and speech with limited voluntary movement, increased tone, and preserved wakefulness.

Video 3.24 (C3c24): Catatonia Mimicking Parkinsonism

Psychiatric catatonia presenting with rigidity, posturing, immobility, and marked psychomotor slowing.

Video 3.25 (C3c25): Normal Pressure Hydrocephalus (NPH)

Wide-based hesitant gait with preserved seated examination, positive pull test, and ventriculomegaly on MRI.

Video 3.26 (C3c26): NPH Responsive to CSF Diversion

Wide-based shuffling gait and impaired turning that improved following lumbar drainage and ventriculoperitoneal shunting.

Video 3.27 (C3c27): NPH with Freezing of Gait

Magnetic gait, start hesitation, freezing, and postural instability that markedly improved after lumbar drainage and VP shunt placement.

Video 3.28 (C3c28): NPH with Severe Magnetic Gait

Profound gait ignition failure and magnetic gait with substantial improvement after CSF drainage and shunting.

Video 3.29 (C3c29): NPH with Long-Term Shunt Benefit

Magnetic shuffling gait and postural instability demonstrating sustained improvement after lumbar drainage trial and VP shunt surgery.

Parkinson’s Disease - Phenomenology Atlas

Parkinson’s Disease - Phenomenology Atlas

Video 2.1 (C2c8): Early Parkinsonism with Left Foot Tremor

Slight left-sided bradykinesia with decrement on finger and foot tapping, accompanied by a positional 4 to 5 Hz left foot tremor. Gait was preserved.

Video 2.2 (C2c27): Parkin-Associated PD with Foot Dystonia

Young-onset parkinsonism with marked symptomatic response to levodopa. Examination showed impaired left foot tapping and task-induced left foot dystonia during walking, while running and backward walking remained normal.

Video 2.3 (C2c31): Typical Asymmetric Parkinson's Disease

Classic parkinsonian features including facial masking, reduced blink rate, hypophonia, mild left-predominant bradykinesia, and reduced left arm swing.

Video 2.4 (C2c33): Off-State Parkinsonism with Micrographia

Right-sided rest tremor, bradykinesia, cogwheel rigidity, and reduced arm swing in the medication off state. Progressive micrographia was demonstrated during writing.

Video 2.5 (C2c43): Advanced PD with Rest Tremor

Moderate parkinsonism with facial masking, prominent right-hand rest tremor, bilateral bradykinesia, right-sided cogwheeling, and reduced right arm swing.

Video 2.6 (C2c50): LRRK2-Associated Parkinson's Disease

Asymmetric left-sided parkinsonism characterized by bradykinesia, impaired left foot tapping, and markedly reduced left arm swing. Genetic testing confirmed an LRRK2 G2019S mutation.

Video 2.7 (C2c51): Pseudo-Hemiparetic Parkinson's Disease

Marked unilateral slowness and rigidity producing a hemiparetic appearance, despite preserved ability to run normally.

Video 2.8 (C2c52): Parkin-Associated Early-Onset PD

Mild facial masking, bilateral resting tremor, appendicular bradykinesia, and left foot inversion during gait.

Video 2.9 (C2c56): Dopamine Agonist-Induced Anterocollis

Moderate anterocollis with preserved neck strength secondary to rotigotine therapy, which improved substantially after drug discontinuation.

Video 2.10 (C2c68): Advanced PD with Dyskinesia and Retro-Arm-Swing

On-state dyskinesias involving the head, neck, trunk, and left side of the body, with characteristic retro-arm-swing during backward walking.

Video 2.11 (C2c69): Severe Generalized Levodopa-Induced Dyskinesia

Profound generalized dyskinesias affecting the head, trunk, arms, and legs, with bilateral retro-arm-swing during gait.

Video 2.12 (C2c70): Advanced PD with Unilateral Retro-Arm-Swing

Moderately severe on-state dyskinesias of the arms and trunk, accompanied by prominent right-sided retro-arm-swing during walking.

Video 2.13 (C2c71): Early-Onset PD, Motor Fluctuations, and STN-DBS

Advanced early-onset Parkinson's disease with severe motor fluctuations and dyskinesias successfully treated with STN deep brain stimulation. Residual action-induced right foot dystonia improved with trihexyphenidyl and botulinum toxin.

Video 2.14 (C2c80): Orthostatic Tremor in Parkinson's Disease

Fine high-frequency leg tremor developing after standing, relieved by light touch and walking, consistent with orthostatic tremor.

Video 2.15 (C2c81): Parkinsonian Camptocormia with Sensory Trick

Walking-induced camptocormia that improved with sensory tricks including hand positioning, backpack use, and ski poles.