This is just an amazing explanation . Someone said give him a bigger board. haha, I prefer the board small, Simple and Effective . Big can get confusing
Wonderful video. Wondering if anyone here has any resources they recommend on normative values of eye movement with geriatric population ( false positives etc...)
Thank u so much.. this topic takes hours to understand ,,not talking about retention...😜...and u there explained it in few minutes and that too swiftly...
Your thoughtfulness and thoroughness contributed to speeding up my healing process. I wonder what could have become of me if you weren’t the one who handled my case. Thank you for curing my HSV2 dr popoola.
Notes to self: Key: - FEF = Frontal Eye Field - POTR = Parietal Occipital Temporal region - FCPW = Final Common Pathway - PPF = Parapontine Formation - TMJ = Thalamo-Mesencephalic Junction - VOR = Vestibulo-occular reflex: talking to eyes w/o the cortex; balance part of ear sensses and transmits info to vertical and horizantal gaze center - I/P-nuclear = Inter / Proper Nuclear: Inputs: same for "Nuclear" refers to the final common pathway for the gaze-type in question: Inputs are the same for Supra-Nuclear, & Nuclear - ORIGIN: --- Both: Verge on IL PPF/(CN6Nuc-->IL-X, CL-MLF-Y) --- Saccade-Start: driven by CL-FEF --- Pursuit-Start: driven by IL-POTR - PATHWAY: Both input-origins verge on IL PPF/(CN6Nuc-->IL-X, CL-MLF-Y) --- SUPRA-Nuclear (ABv>@ TMJ (FEF/PORT)) => VERTICAL(TMJ-nucleus location) ----- Lesion = Moving DOLLEYEs (enabled by working Proper-nuclear region) --- I/P-Nuclear (@/BLo TMJ (TMJ/PeriNerve/Muscle) => HORIZANTAL(Pons/PPF-[CN6]nucleus location) gaze ----- Lesion = Palsied DOLLEYEs -- but Palsied How? ----- can't look up? vertical ----- can't look side? Horizantal - DESTINATION: Both finish in FCPW = X = CN6Fasc + LRMusc; Y = MRMusc --- INFRA-nuclear, FCPW (peripheral N, NMJ, muscle) ----- Lesion = UNMoving DOLLEYEs
How does the POT connect ipsilaterally to the abducens nucleus or PPRF? Do its axons descend into the pons along with other corticopontine fibers bound for the pontine nuclei?
I am so impressed that I was going to comment. But, gosh, however, the comments below strung together, pretty much leaves me without any original praise to add. Thanks from me. Good to know you are teaching the future pros so well.
Many thanks, this is extremely helpful. I don't understand how a uniliateral lesion of PPRF would affect saccades in one direction. Will CN VI function in saccades in absence of the contralateral CN III, or will both be impaired such that neither eye can gaze in that direction?
A unilateral lesion of the PPRF would affect both the ipsilateral CN VI and the contralateral CN III function. Right FGC lesion: both eyes will move toward the lesion Right infranuclear lesion (PPRF): both eyes will move away from the lesion
Thanks, I understand this better than I did 3 weeks ago! My schematic doesn't agree with what you wrote there - mine says that a PPRF lesion on the right side cause you to look away from the lesion - the ipsilateral VI cannott abduct, contralateral III cannot adduct?
Niall Adams You're right! What I actually meant to write was right frontal gaze center lesion instead of right PPRF. A right lesion in the cerebrum would cause the left lateral rectus not to abduct and the right medial rectus not to adduct. :) I'm sorry for any misunderstanding! Cheers!
OmyGod.. give him bigger whiteboard please! This is important topic!
I never would've imagined that so much knowledge could fit on such a small whiteboard.
"Get this man a bigger white board" black panther
Iya teh setuju
Halo teh cece
Teh azal juga
This lecture is like poetry in motion !
This, along with the lecture on INO, is by far the best explanation I have ever heard. Thank you so much for posting this.
This is the best explanation of a topic that confuses many med students and ophthalmology residents! Thank you Dr. Lee
Never seen anyone explain ophthalmology like this. What a huge resource.
the best teacher of neuroanatomy ever.
I would substitute this video for many hours of reading. thanks for sharing Dr .Lee
My brain just broke. I'm actually finally getting my head around these concepts after years. I want more!
This is just an amazing explanation . Someone said give him a bigger board. haha, I prefer the board small, Simple and Effective . Big can get confusing
You are best of the best Sir 👌🏼 👍🏼
wow so clear Greetings from Peru!
Wow what a clean explanation for such a complicated topic
I think I'm just dumb, because this guy explains really well
Brilliant!
Sir you are without doubt the best teacher I have ever seen. I honestly had been pulling my hair out trying to figure this out. Thank you. So. Much.
Amazingly simplified! Thank you sir!!!
Beast. Someone get this man a USMLE video series like Najeeb cuz wow!
Thank YOU!
Amazing lecture , how can he remembers all there complex pathyways like the back of his hand
Genio! Saludos!
This is amazing! I can't believe how long I've been searching for this answer. Thanks.
Brilliant! Beautiful explanation sir
Hands down one of my favorite online educators.
Thank you
Amazing
The best explanation i had ever seen for this topic
Wonderful video. Wondering if anyone here has any resources they recommend on normative values of eye movement with geriatric population ( false positives etc...)
This was just THE MOST EXCELLENT explanation!!! Thanks a lot Dr. Andrew!
Thank u so much.. this topic takes hours to understand ,,not talking about retention...😜...and u there explained it in few minutes and that too swiftly...
between 1:45 and 2:15 was EXACTLY what I've been looking for. Clearly explained with left and right components. THANK YOU DR.
Exactly 😌
Sir.. Indebted to you for life!
Brilliant. Never has this topic been so clear. Thank you!
Neuro-ophthalmology made simple! Thanks Dr. LEE.
Your thoughtfulness and thoroughness contributed to speeding up my healing process. I wonder what could have become of me if you weren’t the one who handled my case. Thank you for curing my HSV2 dr popoola.
Great video
It's awesome. I'm a neurologist in China, I could find answers for unresolved questions for a long time! thanks so much!
Lets award this person with oscars in Neuro-ophthalmology.
Amazing video without a doubt! It cleared my concepts so well! Glad to have such professors' expertise online :)
Dr Lee thank you so much. That was the best explanation
Omg how smart can someone be !!!!!
Amazing work Dr Lee. Making such a complex topic so understandable . Thanks again
by far the best ophthalmology lecture video i seen , my admiration sir
Notes to self:
Key:
- FEF = Frontal Eye Field
- POTR = Parietal Occipital Temporal region
- FCPW = Final Common Pathway
- PPF = Parapontine Formation
- TMJ = Thalamo-Mesencephalic Junction
- VOR = Vestibulo-occular reflex: talking to eyes w/o the cortex; balance part of ear sensses and transmits info to vertical and horizantal gaze center
- I/P-nuclear = Inter / Proper Nuclear:
Inputs: same for
"Nuclear" refers to the final common pathway for the gaze-type in question: Inputs are the same for Supra-Nuclear, & Nuclear
- ORIGIN: --- Both: Verge on IL PPF/(CN6Nuc-->IL-X, CL-MLF-Y)
--- Saccade-Start: driven by CL-FEF
--- Pursuit-Start: driven by IL-POTR
- PATHWAY: Both input-origins verge on IL PPF/(CN6Nuc-->IL-X, CL-MLF-Y)
--- SUPRA-Nuclear (ABv>@ TMJ (FEF/PORT)) => VERTICAL(TMJ-nucleus location)
----- Lesion = Moving DOLLEYEs (enabled by working Proper-nuclear region)
--- I/P-Nuclear (@/BLo TMJ (TMJ/PeriNerve/Muscle) => HORIZANTAL(Pons/PPF-[CN6]nucleus location) gaze
----- Lesion = Palsied DOLLEYEs -- but Palsied How?
----- can't look up? vertical
----- can't look side? Horizantal
- DESTINATION: Both finish in FCPW = X = CN6Fasc + LRMusc; Y = MRMusc
--- INFRA-nuclear, FCPW (peripheral N, NMJ, muscle)
----- Lesion = UNMoving DOLLEYEs
I hope I have a teacher like him in my center
oh my god, this is the video i have been waiting for! thank you!!
How does the POT connect ipsilaterally to the abducens nucleus or PPRF? Do its axons descend into the pons along with other corticopontine fibers bound for the pontine nuclei?
All i memorized that in PSP you will find veryical gaze palsy. Now i have the capability to make other understand
♥ Incredible ♥
What a wonderful explanation!
Plz keep going dr. Lee and don't stop.
Really helpful video! Thanks!!!
ThanQ , that was crystal clear ,wonderful presentation Dr Lee
Hats off to you sir, brilliantly explained. You have just gained a new subscriber
Wow Thank you sir...super clear and concise. Brilliant.
My father died from this terrible disease but until this video I never really understood much about it.
This is the single video available in TH-cam about this explanation.. so please save it.. thanks sir
This dude is a GOAT! Explained that so smoothly
damn, this is just fantastic, what a professor. Thanks one more time for this brilliant lesson
thanks from Belorus!
Super high yield stuff in 7 minutes. You have a gift!
This was a tough topic, explained in only 7 minutes wow
legendary explanation sir , superbly simplified
Can you address oscillopsia due to vestibular neuritis pls?
you're amazing! thank you so much
What are saccades and pursuites movement ?
I'm a big fan! Keep up the great work!
Can't hear you Dr. Please use a microphone.
what sorcery is this!! Thank you Dr. Lee.
Genius
I really would thank you sooooo much! Really u made it sooooo simple! Much much much much love! Thank you so much. Am tearing from appreciation.
I have a question,
What is the rule of the superior collicolus in the horizontal or vertical gaze control?
SC is moslty for vision afaik and not for eyemovements
Complex Neuroophthalmology is simplified! Amazing videos. Just a pleasure to watch, Thanks.
Thank you🙏🏻🙏🏻🙏🏻. Excelent! Subscribed from Brasil!
The great professor ever! Thank you! You explain this clearly within 17 mins that some professors confuse us for 2 hours.
can't thank you enough for youramazing videos breaking things down into digestible piece :)
Excellent Speech, thank you!!
prilliant lecturer ,, smart .. concise ,, empiror of neuro-opthalmology
how you simplified the complicated science is amazing...thank you Dr.
He is amazing neuro teacher
I am so impressed that I was going to comment. But, gosh, however, the comments below strung together, pretty much leaves me without any original praise to add.
Thanks from me. Good to know you are teaching the future pros so well.
just blew my mind. best explanation of this concept i've come across
Awesome.. thanks for this
Who needs textbook when we have you!
Brilliant recap for exams!
Very precise. Thank you.
This video is the best about this topic!!
Какие классные лекции!!! Почему на русском воще ничего не найти??? Учите,ребята английский и будете на голову выше своих коллег.
Can you please elaborate on vertical gaze? Literally nobody explains it.
Absolutely sensational video.
this is not a lecture, this is a symphony played by a clever person many thnx sir
im korean neurologist. This really helps. Thank you
Excellent explanation! Dr. Lee is the best in the biz!!!
Thank you for the super clear explanation! Finally understand why there will be vertical gaze palsy in PSP!
Would you extend your videos to all fields of ophthalmology :)
Nice explanation sir
اشكر امك يا شيخ لي
That was mind blowing. Thank you Dr Lee
good explanation for residents and for teachers themselves :)
This is incredible, my man doesn't stutter or miss at all
Amazing. just amazing
How to contact with Dr. Lee?
Dr Lee is simply the best!!!!!
Many thanks, this is extremely helpful. I don't understand how a uniliateral lesion of PPRF would affect saccades in one direction. Will CN VI function in saccades in absence of the contralateral CN III, or will both be impaired such that neither eye can gaze in that direction?
A unilateral lesion of the PPRF would affect both the ipsilateral CN VI and the contralateral CN III function.
Right FGC lesion: both eyes will move toward the lesion
Right infranuclear lesion (PPRF): both eyes will move away from the lesion
Thanks, I understand this better than I did 3 weeks ago! My schematic doesn't agree with what you wrote there - mine says that a PPRF lesion on the right side cause you to look away from the lesion - the ipsilateral VI cannott abduct, contralateral III cannot adduct?
Niall Adams You're right! What I actually meant to write was right frontal gaze center lesion instead of right PPRF.
A right lesion in the cerebrum would cause the left lateral rectus not to abduct and the right medial rectus not to adduct. :)
I'm sorry for any misunderstanding! Cheers!
I love you doctor u r the best