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
Filters: Collection: ehsl_novel_shw
| Identifier | Title | History | Subject | ||
|---|---|---|---|---|---|
| 201 |
 |
939-6 | Supranuclear Paralysis of Upgaze | The patient is a 71 year old woman who was admitted to the Cardiac Unit following an acute "rush to the head", diaphoresis, and palpitations. She felt she was about to faint. She described seeing gold rings in her vision for a few minutes. Past History: Partial complex seizures since 1987. Th... | Supranuclear Paralysis of Upgaze Infarct; Bilateral Lid Retraction - Collier's Sign; Convergence Retraction Nystagmus; Vertical Oculocephalic Reflex Normal; Skew Deviation; Light/Near Dissociation of the Pupils; Pretectal Syndrome; Top of the Basilar Syndrome; Midbrain Infarct; Supranuclear Paralysi... |
| 202 |
 |
943-3 | Supranuclear Paralysis of Upgaze | The patient is a 37 year old man with a history of intravenous drug abuse, AIDS, and tuberculosis. He presented with a chief complaint of unsteadiness walking for two weeks and vertical diplopia for four days. Past History: Human immunodeficiency Virus (HIV) positive When his CD4 lymphocyte count b... | Supranuclear Paralysis of Upgaze; Bilateral Lid Retraction - Collier's Sign; Convergence Retraction Nystagmus; Vertical Oculocephalic Reflex Normal; Skew Deviation; Pretectal Syndrome; Brainstem Encephalitis; Acquired Immune Deficiency Syndrome; CNS Infection; Supranuclear Paralysis of Upgaze Infect... |
| 203 |
 |
946-3 | Supranuclear Paralysis of Upgaze | The patient is a 58 year old man who was admitted as an emergency with hypersomnolence, gait ataxia and diplopia. On the night before Thanksgiving he went to bed feeling well. He was awoken by a phone call at 2 p.m. on Thanksgiving day having over slept by 7 hours. He got out of bed to answer th... | Supranuclear Paralysis of Vertical Gaze; Convergence Retraction Nystagmus; Vertical Oculocephalic Reflex Normal; Third Nerve Palsy; Pretectal Syndrome Top of the Basilar Syndrome; Thalamic Infarct; Patent Foramen Ovale; Thalamus Infarct; Somnolence |
| 204 |
 |
162-8 | Supranuclear Paralysis of Upgaze | This young child presented with headache and unsteadiness. He was found to have obstructive hydrocephalus, aqueduct stenosis and a medulloblastoma. The constellation of clinical eye signs localized to the Dorsal Midbrain and included: • Supranuclear paralysis of upgaze (saccadic and pursuit move... | Supranuclear Paralysis of Upgaze; Convergence Retraction Nystagmus; Eyelid Retraction - Collier's Sign; Normal Downgaze; Esotropia; Sixth Nerve Palsy; Dorsal Midbrain Syndrome; Obstructive Hydrocephalus; Aqueduct Stenosis; Medulloblastoma; Increased Intracranial Pressure; Unilateral Sixth Nerve Pals... |
| 205 |
 |
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... |
| 206 |
 |
944-6 | Supranuclear Vertical Gaze Palsy | This 58 year old woman was referred to Dr. Robert Brown in March 1995 for evaluation of slurred speech. She remained under his care until her death. On examination she had signs of a pseudobulbar palsy: Dysarthria and dysphagia Diminished palatal movement... | Supranuclear Paralysis of Up and Downgaze Degeneration; Convergence Insufficiency; Slow Hypometric Horizontal Saccades; Saccadic Breakdown of Horizontal Pursuit; Bulbar Palsy; Familial Amyotrophic Lateral Sclerosis; Lou Gehrig's Disease; CNS - Degeneration; Superoxide Dismutase (SOD1) Gene |
| 207 |
 |
165-9 | Supranuclear Vertical Gaze Palsy | The patient is a 60 year old woman who was given a diagnosis of Progressive supranuclear palsy six months before she was referred by the Movement Disorders Clinic for evaluation of difficulty reading. Family History: Negative for neurodegenerative disease. Neuro-ophthalmological examination: Sup... | Global Supranuclear Vertical Gaze Palsy; Convergence Absent; Prominent Stare; Slow Hypometric Horizontal Saccades; Slow Horizontal Pursuit; Vertical Oculocephalic Reflex Normal; Positive Glabella Tap; Progressive Supranuclear Palsy; Steele Richardson Olszewski Syndrome; Supranuclear Paralysis of Up ... |
| 208 |
 |
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" |
| 209 |
 |
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... |
| 210 |
 |
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 | |
| 211 |
 |
947-3 | The Prize: An Interview with David H. Hubel Nobel Laureate Physiology or Medicine 1981 | David H. Hubel is the John Enders University Professor of Neurobiology at Harvard Medical School. Born in Canada of American parents, he grew up in Montreal, graduated from McGill Medical School, and received training in neurology at the Montreal Neurological Institute and Johns Hopkins Hospital. ... | David H. Hubel; Intracellular Microelectrode Recordings of Visual Neurons to Visual Stimuli; AVP Association Areas |
| 212 |
 |
005-1 | Third Nerve Palsy | 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 |
| 213 |
 |
939-2 | Third Nerve Palsy | The patient is a 57 year old man who carried a diagnosis of atrial fibrillation and coronary artery disease post CABAG. He was seen in the Massachusetts General Hospital ER with acute double vision and headache and was admitted. Four days prior to admission (PTA) he developed a bifrontal headach... | Ptosis; Unilateral Third Nerve Palsy; Third Nerve Microinfarct; Oculomotor Nerve; Unilateral Oculomotor Third Nerve Palsy; Fascicular Third Nerve Palsy; Third (Oculomotor) |
| 214 |
 |
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 |
| 215 |
 |
940-3 | Third Nerve Palsy | This patient is a 46 year old woman from Portugal who was admitted to the Massachusetts General Hospital in September 1986 with ophthalmoplegia of the left eye (OS) and signs of aberrant reinnervation of the third nerve. She presented, in August 1985, with an episode of diplopia. The diplopia was s... | Ptosis; Unilateral Third Nerve Palsy; Aberrant Reinnervation of the Third Nerve; Paresis of Abduction; Sixth Nerve Palsy; Oculomotor Nerve; Cavernous Sinus Meningioma; Cavernous Sinus Syndrome; Unilateral Oculomotor Third Nerve Palsy; Unilateral Sixth Nerve Palsy |
| 216 |
 |
932-6 | Third Nerve Palsy | The patient is an 85 year old man with hypertension and Type II diabetes mellitus. He presented with a ten day history of drooping of the left eye, unaccompanied by eye pain or headache. With the lid elevated he had double vision in all directions of gaze. He came to the Massachusetts General Ho... | Ptosis; Unilateral Third Nerve Palsy; Oculomotor Nerve; Microinfarction; Unilateral Oculomotor Third Nerve Palsy; Third Nerve Microinfarct; Fascicular Third Nerve Palsy |
| 217 |
 |
946-6 | 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 |
| 218 |
 |
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 |
| 219 |
 |
165-10 | Titubation Opsoclonus | This 52 year old woman presented with unsteady gait. She was admitted to an outside hospital where a diagnosis was made. 1. Paraneoplastic opsoclonus 2. Paraneoplastic cerebellar syndrome with bilateral limb and gait ataxia and titubation 3. Adenocarcinoma of the breast She was transferred to the M... | Titubation; Opsoclonus; Oscillopsia; Saccadic Oscillations; Paraneoplastic Cerebellar Syndrome; Adenocarcinoma of the Breast; Anti-Ri Antibody; Paraneoplastic Opsoclonus; Divergence |
| 220 |
 |
937-2 | Transient Monocular Blindness | 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 |
| 221 |
 |
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 |
| 222 |
 |
167-10 | Unilateral Horizontal Gaze Palsy | The patient is a 62 year old woman with known hypertension. She was referred by her PCP because she could not move her eyes fully and look left. Neuro-ophthalmological examination: Visual acuity, fields, pupils and fundi normal Ocular Motility: • Slight head turn to the left • Conjugate dev... | Unilateral Horizontal Gaze Palsy; Conjugate Deviation of the Eyes; Normal Convergence; Oculocephalic Reflex Normal; Pontine Infarct; Unilateral Horizontal Gaze Palsy Infarct |
| 223 |
 |
905-1-video | Unilateral Horizontal Gaze Palsy | This 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... | 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... |
| 224 |
 |
922-2 | Unilateral Internuclear Ophthalmoplegia | The 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 peri... | 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... |
| 225 |
 |
163-1 | Unilateral Ptosis | The 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 in... | Unilateral Ptosis; Unilateral Lid Retraction; Myasthenic Lid Twitch; External Ophthalmoplegia; Ocular Myasthenia Gravis; Tensilon Test; Thymolipoma; Generalized Myasthenia Gravis; Unilateral Myasthenia Gravis; Ptosis -- Myasthenic; Lid Retraction; Lid Twitch |