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TitleCreatorDescriptionSubject
26 Myasthenia ThymomaShirley H. Wray, MD, PhD, FRCPA PowerPoint slideshow describing the condition.External Ophthalmoplegia; Generalized Myasthenia Gravis; Myasthenic Lid Twitch; Ocular Myasthenia Gravis; Tensilon Test; Thymolipoma; Unilateral Lid Retraction; Unilateral Myasthenia Gravis; Unilateral Ptosis
27 NeuroblastomaShirley H. Wray, MD, PhD, FRCPPowerPoint slideshow describing the condition.Ataxia; Downbeat Nystagmus; Neuroblastoma; Paraneoplastic Downbeat Nystagmus; Paraneoplastic Opsoclonus; Primary Position Downbeat Nystagmus
28 Palatal TremorShirley H. Wray, MD, PhD, FRCPA PowerPoint slideshow describing the condition.Bilateral Horizontal Gaze Palsy Hemorrhage; Bilateral Horizontal Gaze Palsy; Bilateral Lid Nystagmus; Bilateral Sixth Nerve Palsy; Brainstem Infarct; Degenerative Hypertrophy of the Inferior Olivary Nucleus; Facial Palsy; Facial Weakness; Lesion in the Guillain - Mollaret Triangle; Lid Nystagmus; O...
29 Frontotemporal DementiaShirley H. Wray, MD, PhD, FRCPA PowerPoint slideshow describing the condition.Acquired Ocular Motor Apraxia; Acquired Oculomotor Apraxia; CNS Degeneration; Complete paralysis of Voluntary Horizontal Saccades on Command to Look Left; Frontotemporal Dementia; Impaired Pursuit; Inability to Make a Refixation Saccade on Command to a Target Held on the Left; Normal Voluntary Hori...
30 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
31 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...Nonarteritic Ischemic Optic Neuropathy ; Anterior Ischemic Optic Neuropathy
32 Temporal Arteritis (PowerPoint)AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 74-year-old asthmatic male had acute visual loss OS while watching the Super Bowl in 1994. He was seen the next day by a retina specialist, who noted that his optic disc was normal and referred the patient to a neuro-ophthalmologist, who evaluated him about 40 hours after his visual loss. He wa...Temporal Arteritis
33 Optic Neuropathy with Sinus Disease (PowerPoint)AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThe patient is a 66-year-old man with a history of ethanol abuse. He presented with 3 months of right-sided headache and a few days of progressive visual loss OD to hand motions only. When seen by the orbital service, he had nearly complete ophthalmoplegia and ptosis. Sinus biopsy showed fungus, whi...Optic Neuropathy with Sinus Disease
34 Histiocytosis (PowerPoint)AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 1-year-old child with familial erythrophagocytic lymphohistiocytosis was readmitted with a fever and was noted to have bilateral blindness. The spinal tap showed a protein of 148, with 178 WBC with 98% ""lymphocytes."" This image demonstrates the optic nerve infiltration. He was treated with ra...Optic Nerve Histiocytosis; Histiocytosis
35 Orbital Tumors - Choroidal Folds From Orbital Mass (PowerPoint)AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 30-year-old man had a retrobulbar intraconal mass OS. The CT scans showed a heterogeneous lobulated enhancing mass, 2.2 x 1.9 x 1.8 cm. The case beautifully exhibits chorodial folds. The ultrasound showed internal reflectivity. The patient refused surgery.Choroidal Folds from Orbital Mass
36 Moyamoya Disease (PowerPoint)AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 32-year-old woman was referred with a history of 4 days of loss of vision OD. She had a history of manic depressive illness and IV drug abuse; she had been HIV tested 4 weeks before and was negative. She said she last injected cocaine 5 days before being seen, the night before she awoke with th...Saturday Night Retinopathy; Moyamoya Disease
37 Saturday Night Retinopathy (PowerPoint)AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 32-year-old woman was referred with a history of 4 days of loss of vision OD. She had a history of manic depressive illness and IV drug abuse; she had been HIV tested 4 weeks before and was negative. She said she last injected cocaine 5 days before being seen, the night before she awoke with th...Saturday Night Retinopathy
38 Moyamoya Syndrome (PowerPoint)AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyA 9-year-old boy had recurrent ischemic episodes that had begun 2 years prior to evaluation. A significant right hemiparesis and a significant speech, learning, and memory disorder were present. His noncontrast axial view CT scan demonstrated multiple cerebral infarcts. Cerebral angiography revealed...Moyamoya Disease; Moyamoya Syndrome
39 Periphlebitis in Optic Neuritis (PowerPoint)AAO/NANOS - American Academy of Ophthalmology / North American Neuro-Ophthalmology SocietyThis 35-year-old otherwise-healthy woman developed typical optic neuritis OD with excellent recovery. She had no clinical evidence of multiple sclerosis at that time. She presented in August of 1991, at which time perivenous sheathing was seen in the retinal periphery OU. A limited workup was negati...Periphlebitis in Optic Neuritis
40 Amyotrophic Lateral Sclerosis (Guest Lecture)John Q. Trojanowski, MDThe 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...Saccadic Initiation Deficit of Unilateral Horizontal Gaze; Complete Paralysis of Voluntary Horizontal Saccades on Command to Look Left; Inability to Make a Refixation Saccade on Command to a Target Held on the Left; Normal Voluntary Horizontal Saccadic Eye Movements to the Right; Impaired Pursuit; F...
41 Clivus_ChordomaShirley H. Wray, MD, PhD, FRCPThis 46 year old patient had at age 6, a tendency for the left eye to wander out. Her face photograph at that age shows an exotropia and at age 7, a year later, the exotropia was not quite as prominent. It was assumed that the exotropia was due to a non-paralytic strabismus. Past History: At age 1 f...Esotropia; Abduction Weakness; Sixth Nerve Palsy; Clivus Chordoma; Chordoma
42 Pontine_InfarctionShirley H. Wray, MD, PhD, FRCPThe 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 lasting le...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
43 Constructional ApraxiaShirley H. Wray, MD, PhD, FRCPThe patient is a 72 year old right handed woman who presented in November 1995 with the sudden onset of impaired coordination of visual and motor skills following an inner right ear infection. One of her problems was difficulty sitting on a chair as she tended to place her body incorrectly. By late ...Dressing Apraxia; Apraxia of the Left Hand; Constructional Apraxia; Right Parietal Lobe; Progressive Lobar Atrophy; Degenerative CNS Disease; Apraxia
44 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
45 Brain Control of Horizontal Saccadic Eye Movements (Guest Lecture)Shirley H. Wray, MD, PhD, FRCPIn 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 ...Bilateral Ptosis; Facial Weakness; Complete External Ophthalmoplegia; Bilateral Progressive External Ophthalmoplegia (PEO); Mitochondrial Myopathy; PEO plus Deafness; Cerebellar Degeneration with Ataxia; Chronic Progressive External Opthalmoplegia
46 Essential Palatal TremorShirley H. Wray, MD, PhD, FRCPThe patient is a 25 year old meteorologist from Tennessee who came to Boston in the summer of 1992 to vacation with his family on the Cape. His illness started with flu-like symptoms, low grade fever from 99 to 100F, sweating and episodes of light headedness associated with occasional nausea, indige...Essential Palatal Tremor (Myoclonus); Brainstem Encephalitis
47 Palatal TremorShirley H. Wray, MD, PhD, FRCPSee also: http://content.lib.utah.edu/cdm/ref/collection/ehsl-shw/id/68, http://content.lib.utah.edu/cdm/ref/collection/ehsl-shw/id/247, http://content.lib.utah.edu/cdm/ref/collection/ehsl-shw/id/111, http://content.lib.utah.edu/cdm/ref/collection/ehsl-shw/id/312, http://content.lib.utah.edu/cdm/ref...Palatal Tremor (Myoclonus); Pendular Vertical Oscillations; Unilateral Horizontal Gaze Palsy; Facial Palsy; Pontine Infarct; Degenerative Hypertrophy of the Inferior Olivary Nucleus; Lesion in the Guillain-Mollaret Triangle; Oculopalatal Myoclonus; Oculopalatal Tremor Lid Nystagmus; Bilate...
48 Myasthenia ThymomaShirley H. Wray, MD, PhD, FRCPThe patient is a 46 year old woman who presented in July 1977 with horizontal double vision lasting two weeks. Three weeks later the left upper eyelid started to droop and by the end of the day the eye was closed. She had no ptosis of the right eye and no generalized fatigue. She consulted an intern...Unilateral Ptosis; Unilateral Lid Retraction; Myasthenic Lid Twitch; External Ophthalmoplegia; Ocular Myasthenia Gravis; Tensilon Test; Thymolipoma; Generalized Myasthenia Gravis; Unilateral Myasthenia Gravis; Myasthenic Ptosis; Lid Retraction; Lid Twitch
49 Multiple SclerosisShirley H. Wray, MD, PhD, FRCPThe patient is a 56 year old woman who presented in 1982, at the age of 48, with a one week history of painless loss of vision in the left eye. Past History: Negative for a previous attack of optic neuritis or transient neurological symptoms. Family History: Negative for CNS disease Neuro-ophthalmol...Upbeat Nystagmus; Lid Nystagmus; Square Wave Jerks; Jerk Oscillations; Rotary Nystagmus; Saccadic Pursuit; Saccadic Dysmetria; Multiple Sclerosis; Bilateral Lid Nystagmus; Primary Position Upbeat Nystagmus; Torsional Nystagmus; Horizontal Saccadic Dysmetria
50 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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