(DGC) Former Director of Ophthalmology, National Eye Institute, National Institutes of Health, U.S. Department of Health and Human Services
Subject
Chiari Malformation
Description
Clinical Signs: good saccades especially on downgaze; nystagmus. Presenting Symptoms: downbeat nystagmus. 2/25/82: 55 year old man who has had 3 MI's and a history of left hemianopia about 10 years ago recent difficulty in walking and speaking for 2-3 days. Then comatose. Patient seen at V.A. hospital with Fred Chu who took VIDEOS. Examination showed tetraplegia and inhability to speak or move head. Was thought to be unconscious but Dr. Kolsky noted he blinked his lids in response to a command and surprisingly was found To be alert. Eyes showed parlay of horizontal gaze with slight abducting movements. Irregular of ears is said to have shown abduction of one or both eyes, compatible with INO of 1.5 syndrome. Has a down beat nystagmus which is irregular and downgaze is poorly sustained. Cannot look left or right. Also has a right VLL M paralysis. Lids of left eye have full motion and is retracted on look up, i.e. curious dissociation of eye lid movement. 3/6/82: Pre in N.O rds by Dr. Kunentus. See protocol in files. Disease/ Diagnosis: Arnold Chiari Malformation
