Videos, clinical notes and related presentations concerning neuro-ophthalmological and neurovisual disorders collected during Dr. Wray's work as the Director of Neuro-Visual Disorders at Massachusetts General Hospital.
Shirley H. Wray, M.D., Ph.D., FRCP, Professor of Neurology Harvard Medical School, Director, Unit for Neurovisual Disorders, Massachusetts General Hospital.
NOVEL: https://novel.utah.edu/
TO
| Identifier | Title | History | Subject | ||
|---|---|---|---|---|---|
| 51 |
 |
Palatal_Tremor | Palatal Tremor | Palatal Tremor; Acquired Pendular Oscillations; Ocular Myoclonus; Inferior Olive; Oculopalatal Tremor Rhythmic Hyperactivity | |
| 52 |
 |
Paraneoplastic_Ocular_Flutter | Paraneoplastic Ocular Flutter | The 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 ... | Ocular Flutter; Oscillopsia; Trunkal Ataxia; Paraneoplastic Cerebellar Syndrome; Small Cell Carcinoma of the Lung; Paraneoplastic Ocular Flutter; Flutter |
| 53 |
 |
Paraneoplastic_Opsocolonus | Paraneoplastic Opsocolonus | This patient is the index case of the Anti-Ri antibody, published in Annals of Neurology in 1988 (4). The Anti-Ri antibody is recognized to be a paraneoplastic marker in patients with breast and gynecological malignancies (10). The history of this case is particularly important because she was in... | Opsoclonus; Ocular Flutter; Oscillopsia; Saccadic Oscillations; Paraneoplastic Cerebellar Syndrome; Adenocarcinoma of the Breast; Anti-Ri Antibody; Paraneoplastic Opsoclonus; Paraneoplastic Ocular Flutter; Saccadomania |
| 54 |
 |
Paraneoplastic_Upbeat_Nystagmus | Paraneoplastic Upbeat Nystagmus | This 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 ... | Upbeat Nystagmus; Lid Nystagmus; Square Wave Jerks (Saccadic Oscillations); Saccadic Dysmetria; Saccadic Pursuit; Paraneoplastic Syndrome; Paraneoplastic Upbeat Nystagmus; Pancreatic Endocrine Carcinoma; Anti-Hu - Associated Paraneoplastic Encephalitis |
| 55 |
 |
Parasellar_Meningioma | Parasellar Meningioma | This 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... | Ptosis; Third Nerve Palsy; Aberrant Reinnervation of the Third Nerve; Oculomotor Nerve; Parasellar Meningioma; Cavernous Sinus Syndrome; Unilateral Oculomotor Third Nerve Palsy; Unilateral Third Nerve Palsy |
| 56 |
 |
Parkinsons_Disease | Parkinson's Disease | Parkinson's Disease | |
| 57 |
 |
Parkinsons_Disease_guest_lecture | Parkinson's Disease (Guest Lecture) | Parkinson's Disease | |
| 58 |
 |
Pendular_Oscillations | Pendular Oscillations | This 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. ... | Pendular Horizontal Oscillations; Left Beating Nystagmus; Obtrusive Saccades; Bilateral Gaze Evoked Nystagmus; Saccadic Dysmetria; Oscillopsia; Titubation; Ataxia; Multiple Sclerosis; Primary Position Horizontal Nystagmus; Gaze Evoked Horizontal Nystagmus; Horizontal Saccadic Dysmetria |
| 59 |
 |
Pendular_Vertical_Oscillations | Pendular Vertical Oscillations | Pendular Vertical Oscillations | |
| 60 |
 |
Pontine_Infarction | Pontine Infarction | The 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... | Unilateral Internuclear Ophthalmoplegia; Unilateral Horizontal Gaze Palsy; Upbeat Nystagmus on Upgaze; Convergence Normal; Fisher's One-and-a-Half Syndrome;Pontine Infarct; Unilateral Horizontal Gaze Palsy Infarct; Abducting Nystagmus |
| 61 |
 |
Progressive_External_Ophthalmoplegia | Progressive External Ophthalmoplegia | Progressive External Ophthalmoplegia | |
| 62 |
 |
Progressive_Supranuclear_Palsy | Progressive Supranuclear Palsy | Progressive Supranuclear Palsy | |
| 63 |
 |
Saccades_guest_lecture | Saccades (Guest Lecture) | "Normal Eye Movements; Examination, Ocular; Saccades; Optokinetic Nystagmus Drum (OKN Drum); Pursuit; Ocular Motility" | |
| 64 |
 |
Selective_Saccadic_Palsy | Selective saccadic palsy | This case is published courtesy of Scott D.Z. Eggers, M.D., Department of Neurology, Mayo Clinic College of Medicine (1). The patient is a healthy 50 year old woman who underwent otherwise uncomplicated aortic valve replacement for an incidentally discovered ascending aortic aneurysm. Upon awakeni... | Selective Saccadic Palsy after Cardiac Surgery; Supranuclear Gaze Palsy; Ocular Motility; Bilateral Horizontal Gaze Palsy Hypoxia; Pontine Hypoxia; Cerebral Hypoxia |
| 65 |
 |
Supranuclear_Paralysis_of_Downgaze | Supranuclear Paralysis of Downgaze | John Trojanowski and I published this case in Neurology in 1980.(12) At that time, it was one of the first of five reports in the literature of the pathological localization of lesions in the midbrain that are responsible for selective supranuclear paralysis of downgaze. This case is of particula... | Somnolence; Supranuclear Paralysis of Downgaze; Vertical Oculocephalic Reflex Normal; Absent Convergence; Skew Deviation; Ocular Tilt Reaction; Artery of Percheron; Midbrain Infarct; Supranuclear Paralysis of Downgaze Infarct |
| 66 |
 |
Supranuclear_Paralysis_of_Vertical_Gaze | Supranuclear Paralysis of Vertical Gaze | This case was presented to the Clinical Eye Movement Society at the American Neurological Association Meeting in October 2007. The patient is a healthy, 36 year old Lieutenant Commander in the Coast Guard who was last seen perfectly well at 2 a.m. on the day of admission. He awoke in the morning ... | Somnolence; Global Supranuclear Paralysis of Vertical Gaze; Absent Vertical Saccades and Pursuit Movements; Intact Convergence; Convergence Retraction Nystagmus; Ocular Dysmetria; Ocular Tilt Reaction; Lateropulsion; Unilateral Midbrain and Thalamic Infarct; Supranuclear Paralysis of Up and Downgaze... |
| 67 |
 |
Tauopathies_guest_lecture | Tauopathies (Guest Lecture) | A contemporary way to consider a set of neurodegenerative diseases based on their molecular signature. | "Alzheimer's Disease; Dementia Pugilistica; Guam ALS/PD; Pick Disease; Argyrophilic Grain; Dementia; Nieman-Pick, Type C; SSPE; PSP; MSA; Corticobasoganglionic Degeneration; FTDP-17; Postencephalitic PD; Autosomal recessive PD" |
| 68 |
 |
Thalamic_Infarct | Thalamic Infarct | The 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... | Somnolence; Bilateral Ptosis; Supranuclear Paralysis of Downgaze; Vertical Oculocephalic Reflex Normal; Absent Convergence; Horizontal Gaze Evoked Nystagmus; Top of the Basilar Syndrome; Artery of Percheron; Thalamic Infarct; Supranuclear Paralysis of Downgaze Infarct; Thalamus Infarct; Downgaze Pal... |
| 69 |
 |
Thalamic_Stroke_and_Disordered_Sleep_guest_lecture | Thalamic Stroke and Disordered Sleep (Guest Lecture) | Paramedian Thalamic Stroke; Inferolateral Infarct; Tuberothalamic Infarct; Posterior Choroidal Artery Infarct; Hypersomnia; Neuropsychological Deficits; Eye Movement Disturbances | |
| 70 |
 |
Third_Nerve_Palsy | Third Nerve Palsy | The patient is a 50 year old man with Type II Diabetes who presented to an outside hospital in September 1996 with ptosis and an inability to open the right eye. Five months prior to admission (PTA), he had flu-like symptoms with mild fever, sinus congestion and diffuse myalgia in the chest, abdo... | Ptosis; Unilateral Third Nerve Palsy; Oculomotor Nerve; Meningovascular Syphilis; Heubner's Arteritis; Unilateral Oculomotor Third Nerve Palsy; Third Nerve Microinfarct |
| 71 |
 |
Thyroid_Associated_Orbitopathy | Thyroid Associated Orbitopathy | The classical eye signs of thyroid associated ophthalmopathy (TAO) of Graves' Disease is illustrated by case ID925-4. This 50 year old woman with TAO is included in the collection because she illustrates very well lid lag (persistent elevation of the upper eyelid in downgaze) - von Graefe sign E... | Lid Lag; Bilateral Exophthalmos; Restrictive Orbitopathy of Graves' Disease |
| 72 |
 |
Transient_Monocular_Blindness_guest_lecture | Transient Monocular Blindness (Guest Lecture) | The 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... | Sunlight Provoked Transient Monocular Blindness; Low Pressure Retinopathy; Ipsilateral Internal and External Carotid Occlusive Disease; Ischemic Eye Syndrome; Retinal Stroke; Transient; Transient Visual Loss; Ocular Ischemic Syndrome |
| 73 |
 |
Upbeat_Nystagmus | Upbeat Nystagmus | The patient, a 36 year old Italian, presented in October 1967, at the age of 27, with acute dizziness and ataxia. He was evaluated in Rome. A pneumoencephalogram showed hydrocephalus, attributed to arachnoiditis, and a ventriculo-atrial shunt was placed. Three months post shunt placement he ... | Upbeat Nystagmus; Saccadic Hypermetria; Saccadic Pursuit; Square Wave Jerks; Oscillopsia; Cerebellar Astrocytoma; Primary Position Upbeat Nystagmus; Horizontal Saccadic Dysmetria |
| 74 |
 |
Visual_Neglect | Visual Neglect | Visual Neglect | |
| 75 |
 |
Whipples_Disease_guest_lecture | Whipple's Disease (Guest Lecture) | The patient is a 44 year old woman with a past history of ethanol abuse. She was transferred to the Massachusetts General Hospital (MGH) on 3/10/93 for evaluation of memory impairment, hypothalamic dysfunction and a one month history of diplopia and ataxia. In February 1992 (13 months PTA), she ... | Somnolence; Supranuclear Paralysis of Up and Downgaze; Vertical Gaze Palsy; Absent Convergence; Pendular Vergence Oscillations; Bilateral Lid Nystagmus; Tropheryma Whippelii - Infection; CNS Whipple's Disease; Supranuclear Paralysis of Up and Downgaze Infection - Whipple's Disease |