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TitleCreatorDescriptionSubject
1 Alcoholic Cerebellar DegenerationShirley H. Wray, MD, PhD, FRCPSlideshow describing condition.Alcoholic Cerebellar Degeneration; Dysmetria; Gait Ataxia; Gaze Evoked Horizontal Nystagmus; Horizontal Gaze Evoked Nystagmus; Horizontal Saccadic Dysmetria; Horizontal Saccadic Hypermetria; Saccadic Pursuit; Square Wave Jerks
2 Alcoholic Cerebellar DegenerationShirley H. Wray, MD, PhD, FRCPThe patient is a 72 year old woman who presented with a 4 year history of progressive difficulty with balance, frequent falls and unsteadiness walking. She required a cane to steady herself. Past History: Significant for alcohol abuse. In 1980, she came to Boston for a second opinion and was seen in...Square Wave Jerks; Dysmetria; Horizontal Saccadic Hypermetria; Horizontal Gaze Evoked Nystagmus; Saccadic Pursuit; Gait Ataxia; Alcoholic Cerebellar Degeneration; Gaze Evoked Horizontal Nystagmus; Horizontal Saccadic Dysmetria; Alcohol
3 Bilateral Internuclear OphthalmoplegiaShirley H. Wray, MD, PhD, FRCPSlideshow describing condition.Abducting Nystagmus; Bilateral Internuclear Ophthalmoplegia; Botulinum Toxin Therapy; Gaze Evoked Upbeat Nystagmus; Horizontal Pendular Nystagmus; Lid Nystagmus; Multiple Sclerosis; Pendular Horizontal Oscillations; Upbeat Nystagmus
4 Bilateral Internuclear OphthalmoplegiaShirley H. Wray, MD, PhD, FRCPThis 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 recove...Bilateral Internuclear Ophthalmoplegia; Pendular Horizontal Oscillations; Lid Nystagmus; Upbeat Nystagmus; Botulinum Toxin Therapy; Multiple Sclerosis; Horizontal Pendular Nystagmus; Gaze Evoked Upbeat Nystagmus; Abducting Nystagmus
5 Brain MRI in Multiple SclerosisAnne G. Osborn, MDSlideshow describing condition.Abducting Nystagmus; Bilateral Internuclear Ophthalmoplegia; Botulinum Toxin Therapy; Gaze Evoked Downbeat Nystagmus; Horizontal Pendular Nystagmus; Horizontal Saccadic Dysmetria; Lid Nystagmus; Multiple Sclerosis; Normal Convergence; Oscillopsia; Pendular Horizontal Oscillations; Saccadic Dysmetri...
6 Brain MRI in Multiple Sclerosis (Guest Lecture)Anne G. Osborn, MDThe 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. Fami...Bilateral Internuclear Ophthalmoplegia; Abducting Nystagmus; Normal Convergence; Gaze Evoked Upbeat Nystagmus; Gaze Evoked Downbeat Nystagmus; Saccadic Dysmetria; Multiple Sclerosis; Horizontal Saccadic Dysmetria
7 Brainstem Cavernous AngiomaShirley H. Wray, MD, PhD, FRCPSlideshow describing condition.Bilateral Horizontal Gaze Palsy Hemorrhage; Bilateral Lid Nystagmus; Cavernous Angioma; Hiccup; Horizontal Gaze Evoked Nystagmus; Lid Nystagmus; Medulla Hemorrhage; Medullary Hemorrhage; Primary Position Upbeat Nystagmus; Upbeat Nystagmus
8 Brainstem Cavernous AngiomaShirley H. Wray, MD, PhD, FRCPThe patient is a 50 year old woman who presented in November 1977 with a transient facial droop, nystagmus, diplopia, dysarthria and vertigo. She was admitted to New England Tufts Medical Center and had an extensive workup including an electroencephalogram, first generation CT brain scan, angiogram ...Upbeat Nystagmus; Lid Nystagmus; Horizontal Gaze Evoked Nystagmus; Hiccup; Medullary Hemorrhage; Cavernous Angioma; Bilateral Lid Nystagmus; Bilateral Horizontal Gaze Palsy Hemorrhage; Primary Position Upbeat Nystagmus; Medulla Hemorrhage; Medulla
9 Cavernous AngiomaShirley H. Wray, MD, PhD, FRCPSlideshow describing condition.Cavernous Angioma; Convergence Normal; Facial Palsy; Fisher's One-and-a-Half Syndrome; Pendular Vertical Oscillations; Pontine Hemorrhage; Unilateral Gaze Palsy Hemorrhage; Unilateral Horizontal Gaze Palsy; Unilateral Internuclear Ophthalmoplegia; Upbeat Nystagmus on Upgaze
10 Cavernous AngiomaShirley H. Wray, MD, PhD, FRCPThe patient is a 19 year old sophomore who presented in 1983 with numbness of the left hand, involving initially just the fingers, and numbness and weakness of the right side of the face. He described the numbness in his hand as if it was "intensely asleep". The facial numbness involved the perioral...Unilateral Internuclear Ophthalmoplegia; Unilateral Horizontal Gaze Palsy; Upbeat Nystagmus on Upgaze; Convergence Normal; Pendular Vertical Oscillations; Facial Palsy; Fisher's One-and-a-Half Syndrome; Pontine Hemorrhage; Cavernous Angioma; Unilateral Gaze Palsy Hemorrhage; Abducting Nystagmus; Fac...
11 Cavernous Sinus MeningiomaShirley H. Wray, MD, PhD, FRCPSlideshow describing condition.Abducting Nystagmus; Cavernous Angioma; Convergence Normal; Facial Palsy; Facial Weakness; Fisher's One-and-a-Half Syndrome; Pendular Vertical Oscillations; Pontine Hemorrhage; Unilateral Gaze Palsy Hemorrhage; Unilateral Horizontal Gaze Palsy; Unilateral Internuclear Ophthalmoplegia; Upbeat Nystag...
12 Chiari I MalformationShirley H. Wray, MD, PhD, FRCPSee also: http://content.lib.utah.edu/cdm/ref/collection/ehsl-shw/id/295, http://content.lib.utah.edu/cdm/ref/collection/ehsl-shw/id/323, and http://content.lib.utah.edu/cdm/ref/collection/ehsl-shw/id/61Downbeat Nystagmus; Oscillopsia; Chiari-1 Malformation; Primary Position Downbeat Nystagmus; Vertical Saccadic Dysmetria; Horizontal Saccadic Dysmetria; Ataxia; Dysmetria; Chiari Malformation
13 Chiari-I MalformationShirley H. Wray, MD, PhD, FRCPA PowerPoint slideshow describing the condition.Ataxia; Chiari-1 Malformation; Downbeat Nystagmus; Dysmetria; Horizontal Saccadic Dysmetria; Lid Nystagmus; Oscillopsia; Primary Position Downbeat Nystagmus; Vertical Saccadic Dysmetria
14 Downbeat NystagmusShirley H. Wray, MD, PhD, FRCPSlideshow describing condition.Downbeat Nystagmus; Oscillopsia
15 Downbeat NystagmusShirley H. Wray, MD, PhD, FRCPThis 58 year old engineer was referred by his neurologist for evaluation of periodic episodes of difficulty focusing and blurred vision for 8 years. In 1981 whilst sightseeing in Newport, he became acutely aware of difficulty focusing and blurry vision. The symptoms lasted for twenty minutes and the...Downbeat Nystagmus; Oscillopsia; Primary Position Downbeat Nystagmus
16 Downbeat Nystagmus PANShirley H. Wray, MD, PhD, FRCPSlideshow describing condition.Downbeat Nystagmus; Periodic Alternating Nystagmus; Multiple Sclerosis
17 Downbeat Nystagmus PANShirley H. Wray, MD, PhD, FRCPThis patient carries a diagnosis of multiple sclerosis. See also: http://content.lib.utah.edu/cdm/ref/collection/ehsl-shw/id/317Downbeat Nystagmus; Periodic Alternating Nystagmus; Multiple Sclerosis; Primary Position Downbeat Nystagmus
18 Eyebrow SpasmDaniel J. Costello, MDSlideshow describing condition.Bipolar Affective Disorder; Epileptic Seizures; Primary Position Left Beating Nystagmus; Rhythmic Eyebrow Spasm; Torsional Nystagmus; Tuberous Sclerosis Complex (TSC-2 DNA sequence variant)
19 Eyebrow Spasm (Guest Lecture)Shirley H. Wray, MD, PhD, FRCPThis case is published courtesy of Daniel J. Costello, M.D., Department of Neurology, Massachusetts General Hospital, Boston. The patient is a 32-year-old right-handed man with an established diagnosis of Tuberous Sclerosis Complex characterized by: -medically intractable epilepsy -developmental del...Rhythmic Eyebrow Spasm; Torsional Nystagmus; Primary Position Left Beating Nystagmus; Epileptic Seizures; Tuberous Sclerosis Complex (TSC-2 DNA sequence variant); Bipolar Affective Disorder
20 Horizontal Gaze PalsyShirley H. Wray, MD, PhD, FRCPThis 56 year old woman with known adenocarcinoma of the breast presented with the recent onset of horizontal diplopia and deviation of her left eye inwards. Her oncologist referred her for a neuro-ophthalmic evaluation. This 56 year old woman with known adenocarcinoma of the breast presented with th...Unilateral Horizontal Gaze Palsy; Esotropia; Fascicular Sixth Nerve Palsy; Horizontal Gaze Evoked Nystagmus; Normal Convergence; Horizontal Oculocephalic Reflexes Absent; Facial Palsy (Bell's Palsy); Abducens Nuclear Lesion; Pontine Metastasis; Adenocarcinoma of the Breast; Unilateral Sixth Nerve Pa...
21 Internuclear Ophthalmoplegia in ChildhoodShirley H. Wray, MD, PhD, FRCPPowerPoint slideshow describing the condition.Abducting Nystagmus; Bilateral Internuclear Ophthalmoplegia; Medulloblastoma; Upbeat Nystagmus
22 Internuclear Ophthalmoplegia in Childhood (Guest Lecture)Shirley H. Wray, MD, PhD, FRCPThis case was reported by Cogan DG and Wray SH. Internuclear ophthalmoplegia as an early sign of brain tumor. Neurology 1970; 20:629-633. The patient is Case 1. He is a 4 ½ year old boy whose parents noted that the right eye had been "drifting" for four months. On examination the only significant f...Bilateral Internuclear Ophthalmoplegia; Upbeat Nystagmus; Medulloblastoma; Abducting Nystagmus
23 Lessons From Bench BedsideShirley H. Wray, MD, PhD, FRCPSee also: http://content.lib.utah.edu/cdm/ref/collection/ehsl-shw/id/69, http://content.lib.utah.edu/cdm/ref/collection/ehsl-shw/id/282, http://content.lib.utah.edu/cdm/ref/collection/ehsl-shw/id/94, and http://content.lib.utah.edu/cdm/ref/collection/ehsl-shw/id/103Bilateral Internuclear Ophthalmoplegia; Pendular Horizontal Oscillations; Lid Nystagmus; Upbeat Nystagmus; Botulinum Toxin Therapy; Multiple Sclerosis; Horizontal Pendular Nystagmus; Gaze Evoked Upbeat Nystagmus; Abducting Nystagmus; Normal Convergence; Gaze Evoked Downbeat Nystagmus; Sac...
24 Midbrain HemorrhageShirley H. Wray, MD, PhD, FRCPSlideshow describing condition.Cavernous Angioma; Convergence Retraction Nystagmus; Light/Near Dissociation of the Pupils; Midbrain Hemorrhage; Normal Convergence; Pretectal Syndrome; Skew Deviation; Supranuclear Paralysis of Upgaze Hemorrhage; Vertical Oculocephalic Reflex Normal
25 Midbrain HemorrhageShirley H. Wray, MD, PhD, FRCPThe patient is a 49 year old woman who was in good health until January 17, 1991. When, at work one morning, she had an acute attack of light headedness and double vision and collapsed on the floor without loss of consciousness. She developed a severe retro-orbital headache. She was taken to the loc...Supranuclear Paralysis of Upgaze Hemorrhage; Convergence Retraction Nystagmus; Vertical Oculocephalic Reflex Normal; Normal Convergence; Skew Deviation; Light/Near Dissociation of the Pupils; Pretectal Syndrome; Midbrain Hemorrhage; Cavernous Angioma
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