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1 Benign Neonatal Ocular FlutterShortly after birth, this baby was noted to have "jiggling eyes" by his mother. He was in good general health and neurologically intact. Cogan and I saw the baby and Cogan made the diagnosis of neonatal ocular flutter. In 1954 Cogan first used the term "ocular flutter" to describe a rare disorder o...Image/MovingImage
2 Congenital NystagmusThis 11 year old Italian boy was referred for evaluation of nystagmus. Emanuel is the second son in a family of two and his older brother, age 13, had no visual problem. Emanuel was born at term, normal delivery, birth weight 9 pounds. Neonatal and infant development was perfectly normal. A pedia...Image/MovingImage
3 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
4 Hemifacial SpasmThe patient is a 72 year old man with myopia, childhood exotropia, progressive age related ptosis and right hemifacial spasm. Hemifacial spasm (HS) most often begins insidiously in the orbicularis oculi muscle in the early stages, as in this man. He presented with a 2 year history of involuntary t...Image/MovingImage
5 Paralysis of ConvergenceThe patient is a 25 year old man with a long history of headaches due to hydrocephalus. He carries the following diagnoses: 1. Hydrocephalus 2. Aqueduct stenosis 3. Low grade glioma involving the quadrageminal plate 4. Seizures The patient first came to neurological attention at the age of 12 whe...Image/MovingImage
6 Paraneoplastic Ocular FlutterThe patient is a 58 year old woman with known hypertension. In 1994, two weeks prior to admission she had a dramatic change in behavior with insomnia, agitation and depression. This was accompanied by "ringing of hands and anxiety for no apparent reason". She became anorexic, lost 15 pounds ...Image/MovingImage
7 Paraneoplastic Opsoclonus; Downbeat NystagmusThe patient is Case 27-1995 Case Records of the Massachusetts General Hospital (New Eng. J Medicine 1995, 333:579-586). The discusser was Dr. Elizabeth Engle, Associate Professor of Neurology, Harvard Medical School. The baby girl was born after a 30 week gestation, with a birth weight of 1.25 k...Image/MovingImage
8 Supranuclear Paralysis of DowngazeThe patient is a 64 year old man with no major past medical history who, on the day of admission, suddenly developed loss of vision in both eyes and then was unable to open his eyes on his own unless he used his hands. Holding his eyelids open his vision was very blurry. Within minutes he lost con...Image/MovingImage
9 Supranuclear Paralysis of UpgazeThis 84 year old woman carried the following diagnoses: 1. Extrapyramidal movement disorder; Parkinson's disease vs. Progressive supranuclear palsy 2. Hypertension 3. Recurrent left Bell's palsy In 1992, the patient and her family noted that she was drifting to the right when driving. She progress...Image/MovingImage
10 Transient Monocular BlindnessThe patient is a 61 year old lawyer who carried a diagnoses of late onset diabetes mellitus, hypertension, hyperlipidemia, and glaucoma. He presented with transient blurred vision in his left eye (OS) In June 1989 whilst standing in the intense sunlight in the parking lot of a shopping mall, the p...Image/MovingImage
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