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Show /96 UTLlUITLlR£ ABSTRACTS marked vertical pendul.1r ny,-.;tagmus was observl'd again. Tril1L':\yplwnidyl W,lS started again with pWlllpt impwvellwllt. . Tril1L':\vpl1L'llidyl is ,1 drug Cllllllllllllly prescnbed for p,ltie;lts with I'.HkiIlSllll'S dise,lSl' and is r~"ldily ,wail'lble ,1t most pharlll,ll'il's ill the United St,ltl'S. It is difiicult tll dr,lw ,lilY ddinitl' Cllllclusillns from onl' C,lse repllrt lin its ~~lltl'lltial usdulness in vertiC, ll pendul.n nystagmus. Further studies on its l'fiic,Ky ,He ,l\vaitl'd eagerly. Wllita M. /11.'1, M.D. Acute Vertical Ocular Myoclonus. Keanl' JR. Nellrolo'\ lf 1986;36:86-9 (Jan). [Reprint requests to Dr. J. R.· Keane, 1200 N. State St., Los Angeles, CA 90033.) Seven cases are described with pendular, vertical eye movements occurring after pontine strokes'. The rate of the eye movements was 2- 3 cycles per second, and the peak-to-trough amplit~ de ranged from 3 to 45 degrees. A horizontal gaze paralysis was present in all cases. The author refers to these eye movements as acute vertical ocular myoclonus. The eye movements described are similar in character to those seen in palato-ocular myoclonus. In this condition, the patient's palate moves in synchrony with the pendular, vertical eye movements. The author's purpose for presenting the seven cases is that vertical ocular myoclonus can be seen in the absence of palatal movement. Waller M. lay. M.D. Tonic Pupils in Neurosyphilis. Fletcher WA, Sharpe JA. Nellrolvs.lf 1986;36: 188-92 (Feb). [Reprint reguests to Dr. J. A. Sharpe, Division of Neurology, Toronto Western Hospital, 39lJ Bathurst St., Toronto, Ontario, Canada M5T2S8.] Of 60 patients with tonic pupils, 2lJ had serologic tests for syphilis. Five patients had positive blood serology and confirmatory tests; four had manifestations of neurosyphilis and positiw cert:.'brospinal fluid serology. All seropositiw patients had bilateral tonic pupilS. Argyll Robertson pupils are bilateral, miotic, and irregular in shape. They react poorly to light, but briskly to near stimuli. Tonic pupils owr time J Gill NCllf,I-t,,'hflltlIIllO'. Vol. I). No. .3. /'180 may become small and bilateral. They are alsc poorly reactive to light. However, they m.ay bE differentiated from Argyll Robertson pupils by their tonic reaction to near stimuli. This report emphasizes the importanc~ of ser~logic testing for syphilis in pati~nts With tome pupils, particularly those that are bIlateral. ~he a~thors note that VORL testing alone may be msuffIcient, in that up to 50% of cases of neurosyphilis may give a negative response. Thus, fluorescent treponemaI antibody absorption testing should be performed also. Walter M. Jay, M.D. Vascular Retinopathy in Migraine. Coppeto JR, Lessel 5, Sciarra R, Bear L. Nellrology 1986;36:26770 (Feb). [Reprint reguests to J. R. Coppeto, M.D., 1906 North Main St., Waterbury, CT 06704.) Two patients with migraines are described. Both had experienced years of intermittent monocular visual loss. One \·\,as a 34-vear-old woman with systemic lupus erythematos~swho developed abnormalities of the cilioretinal arterial and retinal venous circulations. The other was a 62-year-old man with hypertension and arteriosclerosis who had a central retinal vein occlusion. Excluding their two cases, the authors reviewed the literature and found 12 cases of retinal \'aso-occlusion ascribed to migraine. The two cases described can be classified as belonging to a subgroup of migraines in which there is a monocular \'isual disturbance presumably from an ocular vasospastic event. This is in contrast to the binocular visual deficits that occur more commonly with classic migraine, presumably from a cerebral vasospastic event. The monocular visual disturbances have been described as "retinaL" ocular," or "anterior visual pathway" migraines. The authors speculate that the concomitant vascular disorders present in their two patients may have contributed to the occlusive events. For their concomitant conditions, both patients were receiving medications used for the treatment of vasospastic diseases. The 34-year-old woman with systemic lupus erythematosus was receiving prednisone. The 62-year-old man was receiving imipramine for depresssion, propranolol for hypertension, and isosorbide for angina pectoris. Walter M. lay, M.D. |