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EHSL - Shirley H. Wray Neuro-Ophthalmology Collection
  • All fields: nerve palsy
(40 results)



Display: 100




    • 163-6

    • Bilateral Internuclear Ophthalmoplegia; Upbeat Nystagmus; Medulloblastoma; Abducting Nystagmus;

    • This case was reported by Cogan DG and Wray SH. Internuclear ophthalmoplegia as an early sign of brain tumor. Neurology 1970; 20:629-633. The patient is Case 1. He is a 4 ½ year old boy whose parents noted that the right eye had been...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 919-2

    • Nuclear Third Nerve Palsy; Bilateral Ptosis; Central Caudal Nucleus; Midbrain Ptosis; Oculomotor Nerve; Thalamic Infarct

    • Patient is a 65 year old woman who presented with acute onset of bilateral ptosis. She awoke one day and found her eyelids half shut and she was unable to see. The lids completely shut and she came to the Massachusetts General Hospital Emergency...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 925-2

    • Bilateral Ptosis; Total External Ophthalmoplegia; Normal Pupils; Facial Diplegia; Areflexia; Acute Inflammatory Demyelinating Neuropathy; Guillian Barre Syndrome – Miller Fisher Syndrome;

    • The patient is a 74 year old woman who one month prior to admission suffered from a non-productive cough, right ear pain, and pharyngitis treated with amoxicillin. On the day prior to admission she awoke with blurred vision and horizontal and...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 944-1

    • Bilateral Ptosis; Total External Ophthalmoplegia; Facial Diplegia; Areflexia; Acute Inflammatory Demyelinating Neuropathy; Guillian Barre Syndrome – Miller Fisher Syndrome; Facial Weakness

    • The patient is a 47 year old attorney who was transferred from an outside hospital to the Massachusetts General Hospital (MGH) for treatmebnt of the Miller Fisher variant of the Guillian Barré syndrome (GBS). On the morning of September 14, 1993,...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 946-2

    • Bilateral Sixth Nerve Palsy; Bilateral Esotropia; CNS Non-Hodgkin’s Lymphoma; Cavernous Sinus Syndrome; Lymphoma;

    • The 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...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 163-3

    • Bilateral Sixth Nerve Palsy; Esotropia; Supranuclear Paralysis of Downgaze; Absent Convergence; Upbeat Nystagmus on Upgaze; Wernicke’s Disease; Supranuclear Paralysis of Downgaze Encephalopathy; Gaze Evoked Upbeat Nystagmus; Wernicke...

    • This patient was known to be a chronic alcoholic. He presented with acute onset of unsteadiness walking which he attributed to double vision. He was unable to give an accurate history and was disoriented for time and place. Neurological...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 169-34

    • Bilateral Sixth Nerve Palsy; Bilateral Esotropia; CNS B-Cell Lymphoma;

    • This patient has CNS B-cell lymphoma involving the dura mater. She presented with a chief complaint of “double vision and a squint is his right eye”. On examination she was found to have bilateral sixth nerve palsy and paralytic...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 165-2

    • Esotropia; Bilateral Abduction Weakness; Bilateral Sixth Nerve Palsy; Clivus Meningioma; Sixth (Abducens)

    • The patient is a 60 year old woman who consulted her ophthalmologist with a chief complaint of double vision looking to the left. He diagnosed of a left sixth nerve palsy. No investigations were done. Two years later she complained of diplopia...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 944-5

    • Voluntary Ptosis; Bilateral Sixth Nerve Palsy; Esotropia; Paresis of Conjugate Upgaze; Acute Inflammatory Demyelinating Neuropathy; Guillian Barre Syndrome – Miller Fisher Syndrome;

    • The patient is a 22 year old man. Five days prior to admission (PTA) he developed a sore throat, non-productive cough and a temperature of 99.8 during the day and chills and diaphoresis at night. Four days PTA he had double vision in primary...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 939-8

    • Bilateral Sixth Nerve Palsy; Bilateral Esotropia; Paraneoplastic Opsoclonus/Flutter; Paraneoplastic Cerebellar Syndrome; Carcinoma of the Breast; Paraneoplastic Opsoclonus;

    • This patient is a 62 year old woman with a six month history of double vision and difficulty walking. In August 1996, she first noted her right upper eyelid twitching followed by dizziness, nausea and vomiting. Soon after her voice became...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 923-5

    • Unilateral Duane’s Syndrome, Type 3; Fourth Nerve Palsy; Localization of a Gene on Chromosome 2q31; Congenital Cranial Disinnervation Syndrome; Sixth Nerve Palsy; Unilateral Sixth Nerve Palsy; Congenital Duane's Syndrome; Duane's Syndrome

    • The patient is a 7 year old boy born two weeks premature with transposition of the major arteries of the heart, four holes in the heart, and an absent spleen. He had cardiac surgery at age 2 days and at age one year and his development was...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 166-26

    • Ptosis; Fascicular Third Nerve Palsy; Fixed Dilated Pupil; Contralateral Limb Ataxia; Claude Syndrome; Midbrain Infarct; Oculomotor Nerve; Unilateral Third Nerve Palsy; Subnuclear; Fascicular Oculomotor (Third) Nerve Palsy; Third Nerve Dysfunction

    • The patient is a 76 year old woman who woke one morning unable to see out of her right eye because of ptosis. She came to the Massachusetts General Hospital emergency room and was admitted. Neurological Examination: Right third nerve palsy...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 941-4

    • 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...

    • The 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...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 166-14

    • 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...

    • This 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...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 929-2

    • Hypertropia; Superior Oblique Paresis; Inferior Oblique Overaction; Fourth Nerve Palsy; Trochlear Nerve; Bielchowsky Test; Head Tilt;

    • The patient is a 64 year old engineer who noted whilst driving around Thanksgiving time double vision with one image on top of the other. Vertical double vision persisted and he was referred to the Massachusetts General Hospital for...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 940-1

    • Hypertropia; Superior Oblique Paresis; Inferior Oblique Overaction; Fourth Nerve Palsy; Trochlear Nerve; Bielchowsky Test; Head Tilt; Fourth (Trochlear);

    • The patient is a 32 year old, left handed chemistry teacher who presented with intermittent vertical double vision. In August 1992 she noted, particularly late in the evening when reading in bed, vertical double vision. The images were one on...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 163-21

    • Nuclear Third Nerve Palsy; Bilateral Ptosis; Bilateral Superior Rectus Palsy; Normal Pupils; Midbrain Infarct; Oculomotor Nerve; Nuclear; Thalamic Infarct

    • The following case is the first patient I saw with a nuclear third nerve palsy. The patient is a 52 year old man with hypertension and hyperlipidemia. He awoke one morning unable to open his eyes. To walk he tilted his head backwards and...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 004-1

    • Ocular Dipping; Bilateral Horizontal Gaze Palsy; Full Vertical Gaze; Locked In Syndrome; Embolic Basilar Artery Occlusion; Bilateral Pontine Infarction; Pontine Infarct; Comatose Patient

    • The 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...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 943-1

    • 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...

    • In 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...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 026-1

    • Sixth Nerve Palsy; Esotropia; Gradenigo’s Syndrome; Unilateral Sixth Nerve Palsy; Sixth (Abducens)

    • The 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....
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 938-3

    • Esotropia; Abduction Weakness; Sixth Nerve Palsy; Clivus Chordoma; Chordoma;

    • This 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...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 169-39

    • Spasm of the Near Reflex; Functional Convergence Spasm; Voluntary Blinking; Voluntary Nystagmus; Spasm of the Near Triad; Convergence Spasm

    • This 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...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 946-3

    • 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;

    • 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...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 943-3

    • 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...

    • 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...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 162-8

    • Supranuclear Paralysis of Upgaze; Convergence Retraction Nystagmus; Eyelid Retraction - Collier's Sign; Normal Downgaze; Esotropia; Sixth Nerve Palsy; Dorsal Midbrain Syndrome; Obstructive Hydrocephalus; Aqueduct...

    • 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:...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 167-11

    • 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 –...

    • The 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...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 939-6

    • 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...

    • 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...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 921-1

    • 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...

    • The 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...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 926-1

    • 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...

    • The 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...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 940-3

    • 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...

    • 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...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 939-2

    • Ptosis; Unilateral Third Nerve Palsy; Third Nerve Microinfarct; Oculomotor Nerve; Unilateral Oculomotor Third Nerve Palsy; Fascicular Third Nerve Palsy; Third (Oculomotor)

    • 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...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 005-1

    • 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;

    • 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...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 946-6

    • Ptosis; Unilateral Third Nerve Palsy; Oculomotor Nerve; Meningovascular Syphilis; Heubner’s Arteritis; Unilateral Oculomotor Third Nerve Palsy; Third Nerve Microinfarct;

    • 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,...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 932-6

    • Ptosis; Unilateral Third Nerve Palsy; Oculomotor Nerve; Microinfarction; Unilateral Oculomotor Third Nerve Palsy; Third Nerve Microinfarct; Fascicular 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...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 167-8

    • Ptosis; Unilateral Third Nerve Palsy; Aberrant Reinnervation of the Third Nerve; Pupil Dilated and Fixed; Oculomotor Nerve; Cavernous Sinus Meningioma; Cavernous Sinus Syndrome; Aberrant Reinnervation;

    • The patient is a 48 year old man from Saudi Arabia who came to the Massachusetts General Hospital for a second opinion and hopefully for surgical correction of ptosis of the left eye (OS). He had a long standing left third nerve palsy due to...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 167-10

    • Unilateral Horizontal Gaze Palsy; Conjugate Deviation of the Eyes; Normal Convergence; Oculocephalic Reflex Normal; Pontine Infarct; Unilateral Horizontal Gaze Palsy Infarct

    • 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...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 905-1

    • 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...

    • 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...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 922-2

    • 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...

    • 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...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 163-1

    • 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...

    • 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...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection



    • 920-1

    • Unilateral ptosis; Positive tensilon test; Ocular Myasthenia Gravis; Unilateral Myasthenia Gravis; Ptosis -- Myasthenic

    • This patient is a 46 year old man who carried a diagnosis of late onset diabetes mellitus and hypertension. In October 1985, five weeks prior to admission, he developed vertical diplopia while playing golf. Drooping of the left upper lid...
    • EHSL - Shirley H. Wray Neuro-Ophthalmology Collection

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