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151 Paraneoplastic Upbeat NystagmusThis case was presented to the Clinical Eye Movement Society at the American Neurological Association Meeting in October 2009. The patient is a 65 year old woman who was in good health until seven weeks prior to admission. On June 22/09 on the return flight from her daughter's wedding in Oregon she ...Image/MovingImage
152 Parasellar MeningiomaThis patient is a 58 year old woman from Peru who, in 1975, developed intermittent headaches and right retro-orbital eye pain. She was seen by several ophthalmologists in South America who were unable to make a diagnosis. In March 1977 she awoke one morning with vertical diplopia most marked on...Text
153 Parkinson's DiseaseText
154 Parkinson's Disease (Guest Lecture)Text
155 Paroxysmal Skew DeviationIn 1970 I saw this unique case with Dr. Cogan. The patient is a 60 year old hypertensive woman with a ten year history of intermittent vertical double vision and oscillopsia. Neurological examination between attacks of diplopia showed: Visual acuity 20/25 OU Visual fields, pupils and fundus exami...Image/MovingImage
156 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
157 Pendular Nystagmus; Horizontal Gaze PalsyThe patient is a 29 year old retarded man with a rare autosomal recessive disorder characterized by congenital absence of conjugate horizontal eye movements, preservation of vertical gaze and convergence and horizontal pendular nystagmus. Ocular motility examination: Conjugate horizontal pendular n...Image/MovingImage
158 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
159 Pendular Vertical OscillationsText
160 Pendular Vertical OscillationsIn 1996 this 50 year old woman had the acute onset of tingling in the left arm and mild ataxia. In 1974 because of progressive symptoms and the onset of double vision attributed to a bilateral sixth nerve palsy, she consulted a neurologist at an outside hospital. She was given a diagnosis of Multip...Image/MovingImage
161 Pendular Vertical OscillationsIn October 1988 this 43 year old Spanish speaking man with a history of hypertension, suddenly became weak and collapsed on the floor. He was taken to an outside hospital where his blood pressure was 220/130. He was lethargic and diaphoretic and had slurred speech and a left facial palsy. A CT s...Image/MovingImage
162 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
163 Pendular Vertical OscillationsThis 60 year old patient presented in 1979 for evaluation of blurred vision watching television and a sense of unsteadiness when walking down stairs. Past History: Hypertension for years A "small stroke" 3 months prior to this evaluation, presenting acutely with dizziness and vertical double vision....Image/MovingImage
164 Pontine InfarctionThe patient is a 62 year old right handed man, status post myocardial infarction in 1989 and on Coumadin. In 1993 he presented with a history of three separate TIAs 1. Instantaneous perioral tingling and/or numbness lasting less than 1 minute. 2. Episodic numbness of the right hand and foot lasti...Text
165 The Prize: An Interview with David H. Hubel Nobel Laureate Physiology or Medicine 1981David H. Hubel is the John Enders University Professor of Neurobiology at Harvard Medical School. Born in Canada of American parents, he grew up in Montreal, graduated from McGill Medical School, and received training in neurology at the Montreal Neurological Institute and Johns Hopkins Hospital. ...Image/MovingImage
166 Progressive External OphthalmoplegiaText
167 Progressive External OphthalmoplegiaThis 48 year old woman, who was first seen by a neurologist in March 1989, with a 7 year history of progressive unilateral ptosis, mild facial weakness and generalized fatigue. On examination she had ptosis of the right eye and bilateral limitation of upward gaze. Myasthenia Gravis was ruled out by...Image/MovingImage
168 Progressive External OphthalmoplegiaThe patient is a retired physician, age 70, who recalls having eye muscle exercises as a child way back in 1924. Years later, she noted difficulty in focusing her eyes on horizontal gaze to the right and left which preceded the onset of bilateral ptosis. She presented in 1985, at age 65, with mark...Image/MovingImage
169 Progressive External OphthalmoplegiaThe patient is an 18 year old girl, first seen in 1990 with a 6 year history of progressive ptosis. In 1986, at age 14, she was seen by an ophthalmologist and pediatric neurologist and investigated. Myasthenia Gravis was ruled out by a negative Tensilon test, negative anti-acetylcholine receptor ...Image/MovingImage
170 Progressive External OphthalmoplegiaIn 1995 I published this case alongside eleven personal cases, three with the Kearns-Sayer Syndrome (KSS) and five with Progressive External Opthalmoplegia (PEO). Am J of Neuroradiol:16 (5);1167-1173. This patient with KSS is still alive in 2009. In 1968, at the age of 15 he presented with a hi...Image/MovingImage
171 Progressive External OphthalmoplegiaIn 1995 I published this case alongside eleven personal cases, three with the Kearns-Sayer Syndrome (KSS) and five with Progressive External Opthalmoplegia (PEO). Am J of Neuroradiol:16 (5);1167-1173. The patient was under the care of Dr. Raymond Adams from age 13 years. In 1991, at age 40 years...Image/MovingImage
172 Progressive Supranuclear PalsyText
173 Pseudo-Internculear OphthalmoplegiaThis 32 year old man had the acute onset of double vision followed very quickly by a drooping of the left eyelid. Past History: Negative for any previous episode of double vision No history of strabismus as a child No fatigue, neck weakness, difficulty in chewing or swallowing Family History: Neg...Image/MovingImage
174 Pseudo-Internuclear OphthalmoplegiaIn 1969 this 54 year old man presented with a one month history of blurry vision which started suddenly one afternoon. He said he was "just not focusing" and he saw two images when he "relaxed his sight". He could see clearly covering one eye. Initially, the difficulty in focusing occurred la...Image/MovingImage
175 Psychogenic BlepharospasmThe patient is a 57 year old woman who presented in 1989, with a 3 year history of frequent eyelid blinking, twitching and twinking. She was under a good deal of stress and anxiety attributed to moving house after 26 years and losing touch with her friends and social activities. She was also conce...Image/MovingImage
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