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Show f. Clin. Neuro-ophthalmol. 3: 223, 1983. JAMES R. KEANE, M.D. Following an episode of pelvic inflammatory disease, a 23-year-old laboratory employee at another hospital became convinced that she had syphilis. Multiple normal serological studies provided no reassurance. She obtained antibiotics surreptitiously from hospital stores and gave herself intramuscular injections of several different antibiotics, including Amphotericin. She then decided that antibiotics would be more efficacious if injected intrathecally. On her first attempt to "reach the subarachnoid space," she made multiple needle passes with injections of Bicillin into the right side of her neck (Fig. 1), before noticing that her eyelid was drooping. On looking in the mirror, she discovered that the right eye was red and the right pupil smaller. When admitted to the Los Angeles County-University of Southern California Medical Center several hours later, a right Homer's syndrome (Fig. 2) proved to be her only neurological abnormality. She was subsequently transferred for psychiatric care. Iatrogenic Homer's syndrome associated with attempts at carotid artery puncture or jugular vein catheterization are fairly common events; one resulting from the patient's own needlework, fortunately, is rare, indeed. Figure 2. (see text). September 1983 Figure I. (see text). 223 |