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Nerve Palsy
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Shirley H Wray, m.d, ...
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Shirley H Wray, m.d, ...
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Shirley H Wray, m.d, ...
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Hypertropia Superior O...
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Bilateral Sixth Nerve ...
(1)
Bilateral Sixth Nerve ...
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Bilateral Sixth Nerve ...
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Esotropia Abduction We...
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1.
Bilateral Internuclear Ophthalmoplegia
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...
2.
Bilateral Ptosis
Nuclear Third Nerve Palsy; Bilateral Ptosis; Central Caudal Nucleus; Midbrain Ptosis; Oculomotor Nerve;
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...
3.
Bilateral Ptosis Facial Diplegia
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...
4.
Bilateral Ptosis Facial Diplegia
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...
5.
Bilateral Sixth Nerve Palsy
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...
6.
Bilateral Sixth Nerve Palsy
Bilateral Sixth Nerve Palsy; Bilateral Esotropia; CNS Non-Hodgkin’s Lymphoma; Cavernous Sinus Syndrome;
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...
7.
Bilateral Sixth Nerve Palsy
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's Disease;
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...
8.
Bilateral Sixth Nerve Palsy
Esotropia; Bilateral Abduction Weakness; Bilateral Sixth Nerve Palsy; Clivus Meningioma;
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....
9.
Bilateral Sixth Nerve Palsy
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...
10.
Bilateral Sixth Nerve Palsy
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...
11.
Duane's Syndrome
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;
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...
12.
Fascicular Third Nerve Palsy
Ptosis; Fascicular Third Nerve Palsy; Fixed Dilated Pupil; Contralateral Limb Ataxia; Claude’s Syndrome; Midbrain Infarct; Oculomotor Nerve; Unilateral Third Nerve Palsy;
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...
13.
Fisher's One and a Half Syndrome
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;
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...
14.
Fisher's One and a Half Syndrome
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;
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...
15.
Fourth Nerve Palsy
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...
16.
Fourth Nerve Palsy
Hypertropia; Superior Oblique Paresis; Inferior Oblique Overaction; Fourth Nerve Palsy; Trochlear Nerve; Bielchowsky Test; Head Tilt;
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...
17.
Nuclear Third Nerve Palsy
Nuclear Third Nerve Palsy; Bilateral Ptosis; Bilateral Superior Rectus Palsy; Normal Pupils; Midbrain Infarct; Oculomotor Nerve;
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...
18.
Ocular Dipping
Ocular Dipping; Bilateral Horizontal Gaze Palsy; Full Vertical Gaze; Locked-In Syndrome; Embolic Basilar Artery Occlusion; Bilateral Pontine Infarction; Pontine Infarct;
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...
19.
Pendular Vertical Oscillations
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; Facial Palsy; Pontomedullary Cavernous Angioma; Bilateral Lid Nystagmus;
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...
20.
Sixth Nerve Palsy
Sixth Nerve Palsy; Esotropia; Gradenigo’s Syndrome; Unilateral Sixth Nerve Palsy;
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...
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