NOVEL - Shirley H. Wray Collection
 
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IdentifierTitleHistorySubject
176 926-4Release HallucinationsThe patient is a 79 year old woman with a chief complaint of visual hallucinations. She carries a diagnosis of glaucoma and cataracts. The patient was in good health until two weeks prior to admission when she noted a black cloud in her visual field in the top central area. The cloud gradually c...Occipital Lobe; Visual Hallucinations; Release Hallucinations; Charles Bonnet Syndrome
177 925-4Restrictive OrbitopathyThis 71 year old woman was referred with bilateral optic neuropathy and thyroid associated ophthalmopathy (TAO) of Graves' Disease. She had been treated for primary hyperthyroidism on three occasions with radioactive iodine and was taking Tapazole 5 mg daily. Neuro-ophthalmological examination: ...Bilateral Lid Retraction; Lid Lag; Bilateral Exophthalmus; Restrictive Orbitopathy of Graves' Disease; Lid Retraction; Thyroid Orbitopathy; Restriction Syndromes; Thyroid Eye Disease; Thyroid-Associated Ophthalmopathy; Blow-Out Fracture; Eyelid Retraction
178 016-1Retinal EmboliTemporary loss of vision in one eye, termed transient monocular blindness (TMB), is the most important visual symptom of arteriosclerotic vascular disease, arteritis and states of altered coagulability and thrombocytosis. In most patients, the visual disturbance during each individual attack of ...Retinal Emboli; Transient Monocular Blindness; Ocular Stroke; Transient; Transient Visual Loss
179 Saccades_guest_lectureSaccades (Guest Lecture)"Normal Eye Movements; Examination, Ocular; Saccades; Optokinetic Nystagmus Drum (OKN Drum); Pursuit; Ocular Motility"
180 945-5Saccadic Initiation Deficit of Horizontal SaccadesThe 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...Cerebral Cortex; Selective Saccadic Palsy - Acquired; Slow Initiation of Horizontal Saccades on Command; Slow Hypometric Horizontal Saccades; Supranuclear Saccadic and Pursuit Upgaze Palsy; Slow Initiation of Horizontal Purusit Tracking a Slow Target; Positive Glabella Tap; Facial Tremor; Alzheimer'...
181 925-3Saccadic Initiation Deficit of Horizontal SaccadesThe 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 ...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...
182 163-2See-saw NystagmusThe patient is a 21 year old woman who was referred to an endocrinologist for evaluation of amenorrhea. She was found to have bitemporal hemianopia and compression of the chiasm. CT Brain showed: A partially cystic, partially solid suprasellar mass with focal calcification consistent with a crani...Pendular See-saw Nystagmus; Bitemporal Hemianopia; Craniopharyngioma
183 207-2Selective Saccadic PalsyThis 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
184 Selective_Saccadic_PalsySelective saccadic palsyThis 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
185 938-3Sixth Nerve PalsyThis 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: ...Esotropia; Abduction Weakness; Sixth Nerve Palsy; Clivus Chordoma; Chordoma
186 026-1Sixth Nerve PalsyThe patient is a 45 year old pharmaceutical executive who, nine days prior to admission, flew back from San Francisco after a hectic business trip feeling jet lagged and fatigued. Inspite of this, four days later, he did a day trip to New York. On the following morning, a Saturday, he awoke with ...Sixth Nerve Palsy; Esotropia; Gradenigo's Syndrome; Unilateral Sixth Nerve Palsy; Sixth (Abducens)
187 924-2Slow Saccade SyndromeThe patient is a 62 year old woman referred from Ireland with a one year history of unsteadiness walking which she first noted following a fall from a chair. Her gait disorder was insidious in onset and may have pre-dated the fall. Since then she had become increasingly unsteady with a tendency to f...Lid Retraction; Supranuclear Paralysis of Up and Downgaze Degeneration; Slow Hypometric Horizontal Saccades; Vertical Oculocephalic Reflex Intact; Progressive Supranuclear Palsy - Tauopathy; Steele Richardson Olszewski Syndrome; CNS - Degeneration
188 939-3Slow Saccade SyndromeIn 1992, this 60 year old woman realized that she was "slowing up", dragging her right foot and walking slowly, and her speech became slurred. She saw a number of physicians and was given the diagnosis of Parkinson's disease and started on Sinemet 50/200 t.i.d. In January 1994, she was seen by a n...Supranuclear Paralysis of Upward Gaze; Slow Hypometric Horizontal Saccades; Square Wave Jerks; Convergence Insufficiency; Positive Glabella Tap; Progressive Supranuclear Palsy - Tauopathy; Steele-Richardson-Olszewski Syndrome; CNS - Degeneration Supranuclear Paralysis of Upgaze Degeneration
189 169-39Spasm of the Near ReflexThis 17 year old boy presented with episodic eye pain. He consulted an ophthalmologist for evaluation of his symptoms and also complained of periodic difficulty focusing. On examination he had periodic spasms of abnormal eye movements, with impairment of full abduction. His ophthalmologist cons...Spasm of the Near Reflex; Functional Convergence Spasm; Voluntary Blinking; Voluntary Nystagmus; Spasm of the Near Triad; Convergence Spasm
190 924-3Spastic Cerebellar Ataxia of Charlevoix-SaguenayThe patient is a 19 year old high school student who carried the diagnosis of autosomal recessive spastic cerebellar ataxia of Charlevoix-Saguenay. He was born at term, walked at 9 months and developed well with normal milestones. At age 10 he began to have difficulty speaking, occasional involuntar...Supranuclear Paralysis of Vertical Gaze; Slow Horizontal Hypometric Saccades; Convergence Absent; Saccadic Pursuit; Saccadic Dysmetria; Vertical Oculocephalic Reflex Normal; Optokinetic Nystagmus Absent; Autosomal Recessive Spastic Cerebellar Ataxia of Charlevoix-Saguenay; Supranuclear Paralysis of ...
191 907-3Supranuclear Paralysis of DowngazeJohn 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
192 Supranuclear_Paralysis_of_DowngazeSupranuclear Paralysis of DowngazeJohn 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
193 944-7Supranuclear Paralysis of DowngazeThe patient is a 62 year old man who, on getting out of bed one morning, found his eyes did not open fully. The right eye hardly opened at all and the left just a little. He staggered to the bathroom and started to floss his teeth and dropped a piece of floss on the floor. He felt unsteady bend...Supranuclear Paralysis of Downgaze; Vertical Oculocephalic Reflex Normal; Impaired Convergence; Exophoria; Ocular Tilt Reaction; Artery of Percheron; Midbrain Infarct; Supranuclear Paralysis of Downgaze Infarct
194 945-2Supranuclear Paralysis of DowngazeThe 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...
195 932-1Supranuclear Paralysis of Up and DowngazeThe 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
196 166-18Supranuclear Paralysis of Up and DowngazeThis patient presented to the Dementia Clinic for evaluation of forgetfulness, impaired recall memory, lack of attentiveness and spontaneity and progressive impairment of mobility over a period of one year. Neurological examination: The patient was found to have multisystem involvement with: 1. Mi...Positive Glabella Tap; Slow Hypometric Horizontal Saccades; Supranuclear Paralysis of Up and Downgaze Degeneration; Progressive Supranuclear Palsy - Tauopathy; Steele Richardson Olszewski Syndrome; CNS - Degeneration
197 921-1Supranuclear Paralysis of UpgazeThe patient is a 33 year old man who called the police to his apartment at 3 a.m. on the morning of admission. They found his apartment in a state of disarray and realized that he had been down on the floor for some hours and only just able to open the door to let them in. He was admitted to the l...Supranuclear Paralysis of Upgaze Hemorrhage; Bilateral Lid Retraction - Collier's Sign; Convergence Retraction Nystagmus; Vertical Oculocephalic Reflex Normal; Normal Convergence; Light/Near Dissociation of the Pupils; Pretectal Syndrome; Thalamic Hemorrhage; Thalamus Hemorrhage
198 936-5Supranuclear Paralysis of UpgazeThis 84 year old woman carried the following diagnoses: 1. Extrapyramidal movement disorder; Parkinson's disease vs. Progressive supranuclear palsy 2. Hypertension 3. Recurrent left Bell's palsy In 1992, the patient and her family noted that she was drifting to the right when driving. She progress...Lid Retraction; Positive Glabella Tap; Supranuclear Paralysis of Saccadic Upgaze; Pursuit Upgaze Intact; Slow Horizontal Hypometric Saccades; Progressive Supranuclear Palsy - Tauopathy; Steele-Richardson Olszewski Syndrome; CNS - Degeneration Supranuclear Paralysis of Upgaze Degeneration; Slow Hypom...
199 926-1Supranuclear Paralysis of UpgazeThe 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 t...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; Cavernous Hemangiomas
200 167-11Supranuclear Paralysis of UpgazeThe patient is a 32 year old man who was admitted as an emergency with severe headache and papilledema. On examination he had signs of the Pretectal Syndrome. • Bilateral lid retraction in primary gaze - Collier's sign • Supranuclear paralysis of upgaze (saccades and pursuit) • Full horizon...Supranuclear Paralysis of Upgaze; Bilateral Lid Retraction - Collier's Sign; Convergence Retraction Nystagmus; Vertical Oculocephalic Reflex Normal; Normal Convergence; Light/Near Dissociation of the Pupils; Pretectal Syndrome; Dysgerminoma - Pineal Region Tumor; Lid Retraction; Upgaze Palsy; Dorsal...
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