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Cerebellar Disease and Saccadic Intrusions

Correspondence: Requests for reprints should be addressed to: Michael X. Repka, M.D., Wilmer 233, Johns Hopkins Hospital, 600 N. Wolfe St., Baltimore, MD 21287-9028. e-mail: mrepka{at}jhmi.edu

Introduction: Cerebellar disease is associated with multiple abnormalities of ocular movement. The cerebellum is critical during head movements to keep the image stabilized on the retina, modulating the response to vestibular input, and matching eye movement to the required change in eye position.

Methods: Literature synopsis.

Results: Recent nonhuman primate evidence suggests a previously unrecognized role in binocular alignment. The most important cerebellar structures in eye movement control appear to be the cerebellar oculomotor vermis and its inputs to the fastigial oculomotor region. Saccadic intrusions range from common square wave jerks to potentially ominous movements like ocular flutter and opsoclonus.

Conclusion: Identification of these types of eye movements of cerebellar origin will lead to appropriate evaluations.