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Show LlTERATU/\L /IH::;nU,CTS 26/ r%S,11 1-·36:841-4 (Jun). [Reprint rt'quests 10 Or. Frisen. \.Jgonkliniken, S"hlgrt'nsk'l sjukhusl'l, S-413 0.15 Goteborg, Sweden.] In sees.1\¥ nvst,lgmus, ont' l'Vt' goes up ,1I1d Intorts whilt' the t1tlwr gOt'S do\'\'n ,1Ild ex lorIs. TIll' cYcle tlwn reVt'rSt'S, usu,ll1v ,1btlUt five times e,Kh second. Set's,1\¥ nYst,lgJl1US is usu,ll1y ,1sstll'ialt'd with a supr,lseliM 111,1SS lesion and bitempor'll hemiant1pia, but it may iollm'\' ,1 br.1instel11 lesion. The autht1rs reptlrt lln ,1 p,lti\.'nt who was Idt with amid chi a sm,11 in iun' and b i It'm po ra I hemiant'pia aflt'r lll',ld 1I-'1l1l11,1. FtlUr months later, she dt've!t1pt'd t\'pical Sl'eS,1\V nystagmus and nwdt'rate l1\'dwcephalus. LUl11bM punctures did nt1t affeLl the nystagmus, but a temporary cessatitlO was dt1CUmented after ingestinn nf ethanol. Wa/ter M. !tIIl, M.D. Fatal Metabolic Acidosis, Hyperglycemia, and Coma after Steroid Therapy for Kearns-Sayre Syndrome, Curless RC, Flynn L Bachynski B, Cregorios JB, Benke P, Cullen R. Neurolosy 1986;36:872-3 (Jun). [Reprint requests to Dr. Curless, Cniversity of Miami School of Medicine, Department of Neurology, Mailman Center 0-820, P.O. Box 016820, Miami, FL 33101. J Kearns-Sane syndrome is characterized by progressive 'exter'nal ophthalmoplegia, heart block, and retinal pigmentary degeneration bdore 20 years of age. Associated features include limb weakness, hearing loss, ataxia, short stature, delayed sexual maturation, and an elevated CSF pmtein. Two adolescent boys with Kearns-S,lVfe syndrome were treated with steroid therapy to increase muscle strength. Both dewloped Idhargy, increasing somnolence, polydipsi<l, polyphagia, and polyuria. Both had hypt'rglycemia and <lcidosis. Nonketotic, lactic acidosis was present in one and ketosis in the other. St'Vefe respiratury failure developed, and both patients died. I'oslmortem examinations reveall'd fatty iniiltration oi the pancreas in addition to a diffuse spongiiurm encephalopathy. Waller M. !ay, M.D. The Clinical Features and Natural History of the Stc ele-Richardson-Olszewski Syndrome (Pro-gressive Supranuclear Palsy). Maher ER, Lees AJ. Nm/'olosy Il.JH6;36:1005-8 Oul). [Reprint requests to Dr. Let'S, The National Hospital for Nervous Disl'ases, Queen Square, London WCIN 3BC, England ·1 The authors feviewed the records of 52 patients with Steele -I~ichardson- Olszewski syndrome. All patienls had supranuclear palsy of downgaze <lnd at least two of the following features: pseudobulbar palsy, dementia, axial or limb rigidity, bradykinesia, pyramidal signs, or gait disorders. There were 22 men and 30 women. The median age at onset of symptoms was 63.5 years with a range of 50-77 years. The median age at diagnosis was 66.5 years. The most common symptoms at onset were unsteady gait, backward falls because of poor balance, visual disturbances, slurred speech, and forgetfulness. Neuro-ophthalmologic findings in 52 patients were as follows: vertical gaze paralysis in 52, horizontal gaze paralysis in 21, blepharospasm in iour, ptosis in four, internuclear ophthalmoplegia in three, nystagmus in three, strabismus in two, lid retraction in two, apraxia of eyelid closure in two, and apraxia oi eyelid opening in one. The median duration from onset to death was 5.9 years, with a median survival after diagnosis of only 1.8 years. Bronchopneumonia was the usual cause oi death recorded on death certiiicates. Walter !\it. !Illl, A1.D. Coincidental Pituitary Adenoma and Parasellar Meningioma: Case Report. Yamada K, Hata\"ama T, Ohta M, Sakoda 1', Ul1ZUl11i T. .\It'lln)~llr,,,t'nl ILJH6; Il):267 -70 (Aug). IRt'print ft'qUt'sts tll Kenji Y,1n1,lda, M.D., Oep,Htn1l'nl of NI'UrllSUr~ef\', Hiroshima Univt'rsit\", Schotll tli l\1t'dicine, Kasumi 1-2-3, Miami-ku, Hiwshim,l, 7Jo.1,l,lp,ln.1 A 52-yt'ar-old Wtll11,ln prt'sented with Clll11plaints of IW,ld,Klw, disturbance tli \'isu,11 acuity, ,md g,ll,lclorrlw,l for II nltlnths. SIll' had nll history lli irr,ldi,ltion or lW,ld traUI11,l. I'h\"sic,11 e"amin, ltion rt'v\.',lit'd mild g,ll,lclorrlw,l, imp,lirl'd visual ,KlI i Iy on Ilw righ I 5idl', bitt'm ptlr,ll Iwmi,1I1llpia, and slighl dderior,ltitHl oi the fight corneal rt'tlex. Axial computed !tll1ltlgr,lphk SC.111 fI.:'Vt',llt'd a IMgt' intrasl'llilr mass with ,1 ring-Ii"\.' \.'nh,lI1ct'ment bv contrast mt'dium. Al10tlwr wl'II-\.'l1h,lIKl'd mass was obs\.'rvt'd ,ldj,Kt'111 10 Ihis 111,15s. CoI'll 11aI Cllmputl'd tomographic S(,1I1 slw\\'vd two pos~iblv dis- |