Eye position-dependent opsoclonus in mild traumatic brain injury

John Ross Rizzo, Todd E. Hudson, Alexandra J. Sequeira, Weiwei Dai, Yash Chaudhry, John Martone, David S. Zee, Lance M. Optican, Laura J. Balcer, Steven L. Galetta, Janet C. Rucker

Research output: Chapter in Book/Report/Conference proceedingChapter


Opsoclonus consists of bursts of involuntary, multidirectional, back-to-back saccades without an intersaccadic interval. We report a 60-year-old man with post-concussive headaches and disequilibrium who had small amplitude opsoclonus in left gaze, along with larger amplitude flutter during convergence. Examination was otherwise normal and brain MRI was unremarkable. Video-oculography demonstrated opsoclonus predominantly in left gaze and during pursuit in the left hemifield, which improved as post-concussive symptoms improved. Existing theories of opsoclonus mechanisms do not account for this eye position-dependence. We discuss theoretical mechanisms of this behavior, including possible dysfunction of frontal eye field and/or cerebellar vermis neurons; review ocular oscillations in traumatic brain injury; and consider the potential relationship between the larger amplitude flutter upon convergence and post-traumatic ocular oscillations.

Original languageEnglish (US)
Title of host publicationMathematical Modelling in Motor Neuroscience
Subtitle of host publicationState of the Art and Translation to the Clinic. Gaze Orienting Mechanisms and Disease
EditorsStefano Ramat, Aasef G. Shaikh
PublisherElsevier B.V.
Number of pages14
ISBN (Print)9780444642547
StatePublished - 2019

Publication series

NameProgress in brain research
ISSN (Print)0079-6123


  • Concussion
  • Eye position-dependence
  • Ocular flutter
  • Opsoclonus
  • Saccades
  • Fixation, Ocular/physiology
  • Ocular Motility Disorders/etiology
  • Humans
  • Middle Aged
  • Brain Concussion/complications
  • Male
  • Eye Movement Measurements
  • Saccades/physiology

ASJC Scopus subject areas

  • General Neuroscience


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