Supranuclear eye movement disorders.

PURPOSE OF REVIEW: This work reviews supranuclear ocular motor disorders, highlighting new data published during the past year.

RECENT FINDINGS: Perceptional adaptative mechanisms may explain recent research concerning the discrepancy between objective measurement of saccade abnormalities and their putative functional visual impairment. Eye movement classes seem to be selectively disrupted by different neurodegenerative disorders. Deep brain stimulation in Parkinson's disease patients may improve pursuit deficits, highlighting the role of basal ganglia in the control of smooth pursuit. Subcortical optokinetic pathways seem to play an important role in maintaining the monocular nasotemporal optokinetic asymmetry seen in patients with infantile esotropia. Vergence-vestibular interaction has been further delineated in patients with idiopathic bilateral vestibular failure. Pharmacological treatment of central vestibular disorders with 4-aminopyridine has been extended to patients with ataxia-telangiectasia in whom it seems to reduce slow-phase velocity of nystagmus.

SUMMARY: Recent data derived from anatomic and functional imaging studies are providing new insights into supranuclear ocular motor circuitry. Novel pharmacological and surgical therapies may have future implications in visual and vestibular rehabilitation of patients with supranuclear eye movement disorders.