What is the name of the most common pursuit abnormality that presents as step-like eye movements?

• A. Cogwheeling
• B. Nystagmus
• C. Saccadic intrusions
• D. Hypometria

Answer: (A)

Cogwheel pursuit describes a pursuit abnormality where tracking a moving target is not smooth but breaks into a series of small, step-like movements. The eyes move in tiny saccades with pauses in between, creating a staircase or cogwheel appearance as they try to follow the target. This reflects disruption in the neural circuits that normally produce continuous smooth pursuit, often involving brainstem and cerebellar pathways.

Nystagmus is an oscillatory, rhythmic movement rather than discrete steps. Saccadic intrusions are brief, rapid eye movements that interrupt fixation or pursuit but don’t typically present as the characteristic stepwise pursuit. Hypometria refers to consistently undershooting a target during saccades, not the step-like pursuit pattern.