NOVEL - Shirley H. Wray Collection
 
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IdentifierTitleHistorySubject
1 Cavernous_AngiomaCavernous AngiomaThe 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...
2 166-11Downbeat NystagmusThe patient is a 72 year old man who was found down and admitted as an emergency in coma. Neurological examination: Patient in coma failed to respond to painful stimuli. Downbeat nystagmus Lid nystagmus Pupils 2 mm OU responsive to light Corneal reflexes absent Oculocephalic reflex absent No resp...Coma; Downbeat Nystagmus; Lid Nystagmus; Bilateral Horizontal Gaze Palsy; Pontine Hemorrhage; Bilateral Horizontal Gaze Palsy Hemorrhage; Primary Position Downbeat Nystagmus
3 164-2Fisher's One and a Half SyndromeThis young patient presented with double vision and was found to have on examination the classical findings of Fisher's one-and-a-half syndrome which are: • Right internuclear ophthalmoplegia on gaze left with adduction weakness OD • Right horizontal gaze paresis with gaze evoked nystagmus • F...Unilateral Internuclear Ophthalmoplegia; Unilateral Horizontal Gaze Palsy; Upbeat Nystagmus on Upgaze; Primary Position Upbeat Nystagmus; Convergence Normal; Fisher's One-and-a-Half Syndrome; Multiple Sclerosis; Unilateral Horizontal Gaze Palsy Demyelination; Gaze Evoked Upbeat Nystagmus; Abducting ...
4 166-14Fisher's One and a Half SyndromeThis young man was seen in the emergency room of his local hospital following the onset of severe headache, mild confusion and diplopia. Non-contrast CT brain scan showed: A right pontine hemorrhage He was transferred to the Massachusetts General Hospital ICU. Ocular Motility: Esotropia of the r...Unilateral Internuclear Ophthalmoplegia; Unilateral Horizontal Gaze Palsy; Convergence Absent; Esotropia; Fisher's One-and-a-Half Syndrome; Facial Palsy; Abducens Nuclear Lesion; Pontine Hemorrhage; Unilateral Gaze Palsy Hemorrhage; Abducting Nystagmus; Facial Weakness
5 941-4Fisher's One and a Half SyndromeThe patient is a 56 year old woman who was seen by a Stroke Consult on the cardiac unit because she had difficulty opening her left eye and diplopia looking to the right. On examination she had ptosis OS and "a partial ophthalmoplegia" sparing the pupil. Diagnosis Partial left third nerve palsy....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; Gaze Evoked Upbeat Nystagmus; Abducting Nystagmus
6 941-6Fisher's One and a Half SyndromeThe 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 lasti...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
7 Horizontal_Gaze_PalsyHorizontal Gaze PalsyThis 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...
8 004-1Ocular DippingThe patient is a 32 year old woman with juvenile diabetes mellitus. She collapsed at home and was rushed to the emergency room where a diagnosis of a locked-in syndrome was made. The term Locked-in Syndrome (LiS) was coined in 1966 by Plum and Posner for a condition with the following criteria: 1....Ocular Dipping; Bilateral Horizontal Gaze Palsy; Full Vertical Gaze; Locked In Syndrome; Embolic Basilar Artery Occlusion; Bilateral Pontine Infarction; Pontine Infarct; Comatose Patient
9 One_and_Half_SyndromeOne and a Half SyndromeOne-and-a-Half Syndrome; Abducens Nucleus; Esotropia of the Ipsilateral eye; Paralytic Pontine Exotropia
10 003-2Palatal TremorThis patient presented with an acute brainstem stroke with: 1. A unilateral lower motor neuron (LMN) facial palsy on the right 2. A horizontal gaze palsy to the right 3. Mild unsteadiness walking The infarct localized clinically to the right side of the pons involving the abducens nucleus and the g...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
11 927-1Palatal TremorThe patient is a 60 year old woman with insulin dependent diabetes mellitus. She was legally blind as a result of diabetic retinopathy and bilateral vitreous hemorrhage. In 1987, she was admitted to her local hospital with slurred speech and a right hemiparesis progressing over a period of three d...Pendular Vertical Oscillations; Palatal Tremor (Myoclonus); Brainstem Infarct; Unilateral Degenerative Hypertrophy of the Inferior Olivary Nucleus; Lesion in the Guillain - Mollaret Triangle; Pontine Infarct
12 936-4Palatal TremorThe patient is a 44 year old left handed man with a history of IV drug abuse (heroin and cocaine) alcoholism, hypertension, and rheumatic fever. In March 1990, at 3 a.m. on the day of admission, he had acute onset of dizziness, slurred speech, left sided weakness and difficulty walking. He was ...Pendular Vertical Oscillations; Lid Nystagmus; Bilateral Horizontal Gaze Palsy; Palatal Tremor (Myoclonus); Pontine Hemorrhage; Degenerative Hypertrophy of the Inferior Olivary Nucleus; Lesion in the Guillain - Mollaret Triangle; Bilateral Horizontal Gaze Palsy Hemorrhage; Facial Weakness; Speech La...
13 923-1Pendular Vertical OscillationsIn October 1988 this 43 year old Spanish speaking man with a history of hypertension, suddenly became weak and collapsed on the floor. He was taken to an outside hospital where his blood pressure was 220/130. He was lethargic and diaphoretic and had slurred speech and a left facial palsy. A CT s...Pendular Vertical Oscillations; Lid Nystagmus; Bilateral Horizontal Gaze Palsy; Palatal Tremor (Myoclonus); Pontine Hemorrhage; Degenerative Hypertrophy of the Inferior Olivary Nucleus; Lesion in the Guillain-Mollaret Triangle; Facial Palsy; Bilateral Lid Nystagmus; Bilateral Horizontal Gaze Palsy H...
14 943-1Pendular Vertical OscillationsIn 1996 this 50 year old woman had the acute onset of tingling in the left arm and mild ataxia. In 1974 because of progressive symptoms and the onset of double vision attributed to a bilateral sixth nerve palsy, she consulted a neurologist at an outside hospital. She was given a diagnosis of Multip...Pendular Vertical Oscillations; Lid Nystagmus; Bilateral Sixth Nerve Palsy; Bilateral Horizontal Gaze Palsy; Palatal Tremor (Myoclonus); Pontine Hemorrhage; Degenerative Hypertrophy of the Inferior Olivary Nucleus; Lesion in the Guillian Mollaret Triangle; Bilateral Horizontal Gaze Palsy Hemorrhage;...
15 Pontine_InfarctionPontine InfarctionThe 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 lasti...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
16 167-10Unilateral Horizontal Gaze PalsyThe 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
17 905-1-videoUnilateral Horizontal Gaze PalsyThis 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...
18 922-2Unilateral Internuclear OphthalmoplegiaThe 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...
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