Quantification of tracking eye movements in patients with neurological disorders

Tracking eye movements were studied in 20 healthy subjects and in 24 patients with vestibular neuronitis, disorders within the frontal cortex, the cerebellum or the brain stem. The tracking tests were performed at six different target velocities between 10-60 degrees s-1 and different parameters were evaluated. The maximum velocity gain of smooth pursuit as normal in the group with vestibular neuronitis but reduced in the groups with disorders within the frontal cortex, cerebellum and the brain stem. The total amplitude of tracking and amplitude of smooth pursuit were normal in the groups with vestibular neuronitis and frontal cortical disorders, while in the groups with cerebellar and brain stem disorders it was reduced. The frequency of superimposed saccades with amplitude range of 3-10 degrees was significantly increased in all groups; however, in the group with vestibular neuronitis the increase was significant only during tracking in the direction of spontaneous nystagmus. The number of superimposed saccades with amplitude range of 11-20 degrees was significantly increased only in the group with cerebellar disorders. The frequency of square waves was not significantly increased in any group. Quantitative analysis of tracking eye movements seems to be a valuable aid for evaluation of site of lesions in the central nervus system.