 One of the hallmarks of congenital misdiagnosis is that the oscillations are in the horizontal plane as can be seen in this patient. And notice that in all directions of gaze they maintain that horizontal plane of motion. This patient's misdiagnosis are more jerking quality than pendular, however, sophisticated eye movement recordings show that most congenital misdiagnosis are a combination of jerk and pendular. Not an up gaze at the patient's misdiagnosis are still maintaining that horizontal oscillation. And as well in down gaze, in this patient's misdiagnosis the oscillations are more pendular than jerk. And again, I'd like you to note that they maintain a horizontal plane. Their variable and that their frequency of oscillation can change somewhat in different positions of gaze. For example, here in right lateral gaze. Another hallmark of congenital misdiagnosis is a null point or position of gaze where the oscillations are at a minimum.