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Cerebral square wave jerks

Neuro-ophthalmology Unit, Division of Neurology, the Playfair Neuroscience Unit, Toronto Western Hospital, and the Departments of Medicine and Ophthalmology, University of Toronto, Toronto, Canada.

Abnormal saccadic intrusions consisting of frequent sporadic horizontal saccades followed, after an interval, by corrective saccades occurred in 70% of 17 patients with acute or chronic focal cerebral lesions. These square wave jerks were significantly lower in amplitude than those in cerebellar system disease. The metrics of these jerks were uniform regardless of the site of cerebral damage. Mean durations approximated the reaction time for saccadic refixations triggered by visual feedback. Very short-latency corrective saccades in some patients are attributed to internal (nonretinal) feedback of eye position errors. Low-amplitude cerebral square wave jerks can be detected clinically by funduscopy.

Address correspondence and reprint requests to Dr. Sharpe, Division of Neurology, Toronto Western Hospital, 3939 Bathurst Street, Toronto, Ontario M5T 2S8, Canada.

This investigation was supported by Medical Research Council of Canada grants ME5509 and MT5404 (Dr. Sharpe), by an Inez Gwendolyn Inglee scholarship, University of Toronto (Dr. Herishanu), and by the Physicians' Services Incorporated Foundation of Ontario (Drs. Sharpe and White).

Presented in part at the thirty-third annual meeting of the American Academy of Neurology, Toronto, Canada, April 1981.

Accepted for publication June 17, 1981.

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