Background: Antibodies to glutamic acid decarboxylase (anti-GAD) can give rise to stiff person syndrome (SPS), an infrequent autoimmune condition of the central nervous system marked by fluctuating muscular rigidity and stimulus-evoked spasms. Disturbances in eye-movement control are rarely identified yet may provide insight into underlying neural involvement. Methods: Two individuals with anti-GAD-related SPS showing distinctive ocular-motor abnormalities were examined with quantitative videonystagmography, supplemented by representative video documentation. Results: Recordings demonstrated varied patterns of ocular-motor disturbance, including reduced smooth-pursuit accuracy, delayed saccadic initiation, dysmetria, intrusive saccades, and several nystagmus types. Partial improvement occurred after immunomodulatory therapy. Conclusions: These findings extend current understanding of the anti-GAD SPS phenotype and indicate that quantitative analysis of eye movements may offer a sensitive, non-invasive marker of disease activity. Larger, prospective studies are needed to clarify prevalence and responsiveness to treatment.

Video Head Impulse Test (v‐HIT) is a valuable tool for diagnosing acute and chronic vestibular disorders but may yield false negatives in acute vestibular neuritis. Clinical judgment remains paramount; integrating patient history, physical findings, and ancillary tests ensures accurate diagnosis, especially when v‐HIT results conflict with the clinical picture and other diagnostic tools.

Background/Objectives: Vestibular evoked myogenic potentials (VEMPs) and the video head impulse test (vHIT) enable receptor-specific assessment of otolithic organs and semicircular canals. Their increasing use has revealed selective or apparently isolated vestibular abnormalities, although the clinical significance of these findings remains uncertain. This mini-review examines selective otolithic and semicircular canal dysfunction, with emphasis on diagnostic interpretation, methodological limitations, and future research needs. Methods: A structured narrative review of PubMed/MEDLINE and Scopus was conducted, focusing on studies reporting isolated, selective, or disproportionate vestibular abnormalities assessed by VEMPs and/or vHIT. Relevant original studies, case series, case reports, reviews, and diagnostic or consensus papers were considered. Results: Selective otolithic dysfunction may involve the utricle, saccule, or both and is often associated with imbalance, tilting, swaying, spatial disorientation, nausea, or postural instability. Selective semicircular canal dysfunction may involve one or more canals and may present with vertigo, dizziness, nystagmus, or gait instability. Similar VEMP and vHIT patterns occur across vestibular neuritis, Ménière’s disease, vestibular migraine, benign paroxysmal positional vertigo, bilateral vestibulopathy, superior semicircular canal dehiscence, vestibular schwannoma, central vestibular disorders, systemic diseases, and idiopathic presentations. Conclusions: Selective vestibular abnormalities should be interpreted as context-dependent laboratory findings rather than discrete disease entities. Their value depends on reproducibility, anatomical plausibility, clinical concordance, complementary testing, and longitudinal follow-up.

Ocular flutter and opsoclonus are rare ocular motor disorders most often associated with paraneoplastic or autoimmune conditions, although their full aetiological spectrum in adults remains incompletely defined. Because the distinction between ocular flutter and opsoclonus may be challenging using routine video-oculographic tracings alone, the broader term flutter-opsoclonus spectrum is used in this study. We conducted a retrospective case series of adult patients evaluated between September 2024 and February 2026 at a tertiary neurology centre, in whom high-frequency saccadic oscillations consistent with the flutter-opsoclonus spectrum were documented using video-oculographic recordings alongside comprehensive neurological assessment. Five patients with distinct underlying disorders were identified, comprising autoimmune, neurodegenerative, prion-related, and demyelinating aetiologies. These included anti-glutamic acid decarboxylase stiff-person spectrum disorder, relapsing anti-NMDA receptor encephalitis with dual antibody positivity, multisystem atrophy of the cerebellar subtype, sporadic Creutzfeldt-Jakob disease, and advanced progressive multiple sclerosis. Flutter-opsoclonus spectrum abnormalities frequently co-occurred with additional ocular motor findings, including saccadic intrusions, various forms of nystagmus, and deficits of smooth pursuit and saccades. This series expands the recognised aetiological spectrum of adult-onset flutter-opsoclonus spectrum abnormalities and highlights their diagnostic value as clinical signs of potentially serious neurological disease. Objective eye-movement recording facilitates detection and should be considered in patients presenting with unexplained cerebellar syndromes, encephalopathies, or complex movement disorders.

Authors are commenting on the evolving geographical incidence trends observed with the genetic form of Creutzfeldt-Jakob disease and discussing the diverse array of factors contributing to the heightened incidence rates observed in specific geographical regions.

Vestibular neuropathy represents the third most common cause of peripheral vestibular disorders. The clinical picture of the disease is characterized by acute vertigo with vegetative accompaniment. A typical course is monophasic with the resolution of symptoms within a few days to complete adjustment. In some patients, secondary complications may occur, which we define into three groups: organic, cognitive, and functional. The occurrence of complications and their persistence is often an overlooked issue, which does not receive sufficient attention and can lead to a significant deterioration in quality of life. Therefore, the management of these patients requires a comprehensive approach and interdisciplinary cooperation between neurologists, physiotherapists, psychologists, and psychiatrists. In the following text, the authors attempt to elucidate this issue further (Fig. 1, Ref. 49). Text in PDF www.elis.sk