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1 Bilateral Internuclear OphthalmoplegiaThe patient is a 25 year old woman who was in excellent health until 4 days prior to admission when she noted blurred vision and horizontal double vision on lateral gaze to right and left. Past History: Negative for strabismus as a child. No previous episodes of transient neurological symptoms. Fa...Image/MovingImage
2 Bilateral Internuclear OphthalmoplegiaThis patient was seen at the Yale Eye Center at the age of 37. She had a long history of multiple sclerosis. At age 22, she had an acute attack of optic neuritis in the left eye which recovered fully within three weeks. Some months later she had a recurrent episode in the same eye, which also ...Image/MovingImage
3 Bilateral Internuclear OphthalmoplegiaThis patient was seen at the Yale Eye Center at the age of 37. She had a long history of multiple sclerosis. At age 22, she had an acute attack of optic neuritis in the left eye which recovered fully within three weeks. Some months later she had a recurrent episode in the same eye, which also ...Text
4 Bilateral Internuclear Ophthalmoplegia (INO)The patient is a 48 year old woman who presented with horizontal double vision looking to the right and to the left. She also noted blurring of vision with the image jerking horizontally back and forth. Neuro-ophthalmological examination: Visual acuity 20/20 OU corrected Visual fields, pupils, and f...Image/MovingImage
5 Downbeat Nystagmus - Periodic Alternating NystagmusThis patient carries a diagnosis of multiple sclerosis.Image/MovingImage
6 Downbeat Nystagmus PANThis patient carries a diagnosis of multiple sclerosis.Text
7 Elliptical NystagmusThe patient carries a diagnosis of multiple sclerosis.Image/MovingImage
8 Fisher's One and a Half SyndromeThis 28 year old woman had severe multiple sclerosis with a spastic paraparesis due to a lesion of the spinal cord. She was admitted to the Intensive Care Unit complaining of dizziness and double vision. Neuro-ophthalmologic examination: Visual acuity 20/30 OU Pupils, visual fields and fundi normal ...Image/MovingImage
9 Fisher's One and a Half SyndromeThis young patient presented with double vision and was found to have on examination the classical findings of Fisher's one-and-a-half syndrome which are: • Right internuclear ophthalmoplegia on gaze left with adduction weakness OD • Right horizontal gaze paresis with gaze evoked nystagmus • F...Image/MovingImage
10 Fisher's One and a Half SyndromeThis 44 year old woman presented in 1973 with an acute attack of optic neuritis in the right eye that fully recovered after a course of ACTH therapy. In 1991, 18 years later, she developed unsteadiness of gait, "walking like a chicken", stiff legs that jerked spontaneously in bed at night, and num...Image/MovingImage
11 Lessons from the Bench and BedsideText
12 MS Time Lapse MRIProfessor Ian McDonald, Institute of Neurology, Queen Square, London contributed this remarkable Time-Lapse MRI of focal MS lesions in a single patient with multiple sclerosis over a period of one year. This time lapse video was assembled from serial T2- weighted MRI scans from a 25-year old wo...Image/MovingImage
13 Multiple SclerosisThe patient is a 56 year old woman who presented in 1982, at the age of 48, with a one week history of painless loss of vision in the left eye. Past History: Negative for a previous attack of optic neuritis or transient neurological symptoms. Family History: Negative for CNS disease Neuro-ophth...Text
14 Ocular FlutterThis patient was seen in the Neurovisual Clinic for evaluation of a monocular attack of optic neuritis which completely resolved. Six months later, she became unsteady walking and was found to have bilateral ataxia. She was given a diagnosis of multiple sclerosis (MS). Neuro-ophthalmological examin...Image/MovingImage
15 Pendular Horizontal OscillationsThis 37 year old woman has had progressive multiple sclerosis (MS) affecting the cerebellum and brainstem for 6 years. Neurological examination: Titubation Dysarthria Incoordination of the extremities Ataxic gait Spastic paraparesis with generalized hyperreflexia and extensor plantar responses. ...Image/MovingImage
16 Pendular OscillationsThis 37 year old woman has had progressive multiple sclerosis (MS) affecting the cerebellum and brainstem for 6 years. Neurological examination: Titubation Dysarthria Incoordination of the extremities Ataxic gait Spastic paraparesis with generalized hyperreflexia and extensor plantar responses. ...Text
17 Pendular Vertical OscillationsThis 36 year old woman had a nine year history of multiple sclerosis (MS) with onset in 1980. In 1989 she was seen in the neurovisual clinic for evaluation of oscillopsia, (an illusion of movement of the visual world). This symptom was accompanied by difficulty in reading because the print was "ju...Image/MovingImage
18 Upbeat NystagmusThe patient is a 56 year old woman who presented in 1982, at the age of 48, with a one week history of painless loss of vision in the left eye. Past History: Negative for a previous attack of optic neuritis or transient neurological symptoms. Family History: Negative for CNS disease Neuro-ophth...Image/MovingImage
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