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1 Aberrant Regeneration of Third NerveGregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of Medicine48 year old woman S/P rupture and repair of right sided posterior communicating artery aneurysm Video shows residual partial right third nerve palsy, with aberrant regeneration, causing a pseudo Von Graefe's sign (elevation of the right upper eyelid with attempted infraduction of the right eye) Se...
2 Acquired HyperopiaAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyChoroidal folds may result from choroidal tumors, compression on the eye wall from thyroid ophthalmopathy, orbital pseudotumor, orbital tumor, posterior scleritis, hypotony, scleral laceration, retinal detachment, marked hyperopia, or secondary to papilledema. Intraocular pressure measurements, refr...
3 Acute Multifocal Pigment Epithelium Epitheliopathy (AMPEE)Gregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of MedicineImages providing example of Acute Multifocal Pigment Epithelium Epitheliopathy (AMPEE)
4 Acute Retinal Necrosis (ARN)Gregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of MedicineAcute Retinal Necrosis causes inflammation and subsequent retinal detachment. This powerpoint provides images depicting ARN.
5 Acute zonal occult outer retinopathy (AZOOR) versus multiple evanescent white dot syndrome (MEWDS)Asim V. Farooq, MD University of Chicago Medicine, Michael T. Andreoli, MD, Wheaton Eye Clinic, Heather E. Moss, MD, Department of Ophthalmology & Visual Sciences, University of Illinois at Chicago College of MedicinePPT case report on acute zonal occult outer retinopathy (AZOOR) versus multiple evanescent white dot syndrome (MEWDS).
6 Alcoholic Cerebellar DegenerationShirley H. Wray, M.D., Ph.D., Professor of Neurology, Harvard Medical School; Director, Unit for Neurovisual Disorders, Massachusetts General Hospital
7 Alcoholic_Cerebellar_DegenerationShirley H. Wray, M.D., Ph.D., FRCP, Professor of Neurology Harvard Medical School, Director, Unit for Neurovisual Disorders, Massachusetts General HospitalThe 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...
8 Alexia_without_AgraphiaShirley H. Wray, M.D., Ph.D., FRCP, Professor of Neurology Harvard Medical School, Director, Unit for Neurovisual Disorders, Massachusetts General HospitalThe patient is a 69 year old left handed man with a history of hypertension, insulin dependent diabetes mellitus and atrial fibrillation. Treated with coumadin, adjusted to keep the INR between 2 and 3. On the morning of admission he awoke at 4 a.m., sat momentarily on the side of the bed and then s...
9 Alzheimers_DiseaseShirley H. Wray, M.D., Ph.D., FRCP, Professor of Neurology Harvard Medical School, Director, Unit for Neurovisual Disorders, Massachusetts General HospitalThe patient is a 78 year old left handed woman with a diagnosis of a left parietal infarct in 1995, bilateral carotid artery stenosis and hypertension. She was first seen in August 1997 for evaluation of involuntary movements of the lower face in the setting of rapidly progressive dementia and was a...
10 Amyotrophic Lateral SclerosisRobert H. Brown, Jr.D. Phil., M.D. Professor and Chair of Neurology University of Massachusetts Medical Center
11 Amyotrophic_Lateral_Sclerosis_guest_lectureJohn Q. Trojanowski, MD, Perelman School of MedicineThe patient is a 68 year old right handed retired air conditioner repair man who presented with impaired balance and slow walking. For about one year he had noted difficulty lifting his feet high enough when climbing the stairs. From that time on, his movements slowed and worsened so that he had dif...
12 AneurysmsAAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyAneurisms may result in neuro-ophthalmologic sign and symptoms by direct compression of the afferent or efferent systems or by the secondary effects of hemorrhage. Basilar aneurisms may result in ocular motor deficits such as a unilateral or bilateral third nerve palsy.
13 Anterior Ischemic Optic Neuropathy (PowerPoint)AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThe patient is a 62-year-old female who presented in August 1996 with visual loss OD that she first noted as loss of her superior field in May 1996. She felt that it had been static since, and perhaps was even a little better in the week before she was seen. There was no pain, even with ocular rotat...
14 Bardet-Biedl SyndromeGregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of MedicinePowerPoint discussing Bardet-Biedl Syndrome, a hereditary condition characterized by rod-cone dystrophy (RP), truncal obesity, polydactyly, hypogonadotropic hypogonadism (males), GU abnormalities (females), and cognitive impairment
15 Best's Vittelform MaculopathyGregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of MedicineThis 14 year old presented with decreased vision, headaches and central scotomas. She was found to have bilateral papilledema related to IIH and also Best's vitilliform maculopathy. The maculas are commonly described as having a "fried egg" sunny side up appearance.
16 Bilateral_Internuclear_OphthalmoplegiaShirley H. Wray, M.D., Ph.D., FRCP, Professor of Neurology Harvard Medical School, Director, Unit for Neurovisual Disorders, Massachusetts General HospitalThis 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...
17 Bilateral_PtosisShirley H. Wray, M.D., Ph.D., FRCP, Professor of Neurology Harvard Medical School, Director, Unit for Neurovisual Disorders, Massachusetts General HospitalThis case, previously reported in 2007, is published courtesy of John Newsom-Davis, M.D., FRCP, FRS, CBE. Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford. This patient was unusual in presenting in early childhood and the development of persistent facial muscle and tongue ...
18 BirdshotGregory P. Van Stavern, MD, Associate Professor, Ophthalmology & Visual Sciences and Neurology, Washington University School of MedicineBirdshot Retinochoroidopathy is a posterior uveitis seen in women 30-60 years of age who present with floaters, changes in color vision, and difficulty with night vision.
19 Blepharospasm_Round_Up_guest_lectureShirley H. Wray, M.D., Ph.D., FRCP, Professor of Neurology Harvard Medical School, Director, Unit for Neurovisual Disorders, Massachusetts General HospitalThe patient is a 60 year old estate manager with a history of retinal laser therapy, dry eyes and age related bilateral ptosis. He carries a diagnosis of hilar lymphadenopathy due to sarcoid and has had cancer of the kidney. He presented in 1995 with a 6 month history of frequent blinking and spasms...
20 Brain_Control_of_Horizontal_Saccadic_Eye_Movements_guest_lectureShirley H. Wray, M.D., Ph.D., FRCP, Professor of Neurology Harvard Medical School, Director, Unit for Neurovisual Disorders, Massachusetts General HospitalIn 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, I ...
21 Brain_MRI_in_Multiple_Sclerosis_guest_lectureAnne G. Osborn, MD, Distinguished Professor of Radiology, Department of Radiology, University of UtahThe 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...
22 Brainstem_Cavernous_AngiomaShirley H. Wray, M.D., Ph.D., FRCP, Professor of Neurology Harvard Medical School, Director, Unit for Neurovisual Disorders, Massachusetts General HospitalThe 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 ...
23 CNS_LymphomaShirley H. Wray, M.D., Ph.D., FRCP, Professor of Neurology Harvard Medical School, Director, Unit for Neurovisual Disorders, Massachusetts General HospitalThe patient is a 70 year old Italian man with atrial fibrillation on long-term coumadin therapy. In October 1995, he developed generalized headache, horizontal double vision and his left eye deviated inwards (esotropia). A diagnosis of left sixth nerve palsy was made and attributed to microvascular ...
24 Carotid Cavernous Fistulas (PowerPoint)AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 76-year-old woman has a 7-month history of redness and pressure sensation in both eyes that is worse in the morning. She has noted intermittent horizontal diplopia during this time. Angiography demonstrated a right dural cavernous sinus fistula, which was successfully occluded with direct injec...
25 Cavernous_AngiomaShirley H. Wray, M.D., Ph.D., FRCP, Professor of Neurology Harvard Medical School, Director, Unit for Neurovisual Disorders, Massachusetts General HospitalThe 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...
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