摘要:

Two case histories, each spanning more than 20 years, demonstrate the complexity and persistence of modern neurosyphilis. Both patients present uncommon manifestations of neurosyphilis that may be easily overlooked today: superior orbital fissure syndrome, posterior fossa gumma, and bilateral deafness. Computed tomographic scans were performed in both patients but were diagnostically nonspecific, and syphilis serology testing in both serum and cerebrospinal fluid was repeatedly misleading. Numerous mistaken diagnoses were put forward until tissue was finally available for histologic examination. Perhaps the most disturbing aspects of these two cases are the persistent failure of specific treponemal serologic testing to indicate the diagnosis, and the inability of repeated “adequate” and/ or supramaximal doses of penicillin to prevent continued neurologic deterioration. We believe that chronic neurosyphilis may demand a reevaluation of current diagnostic and therapeutic practice

ISSN:0272-846X    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0272-846X    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Recent studies utilizing electron microscopy and immunohistochemistry have added to the understanding of the pathology of progressive supranuclear palsy. This article reviews the neuropathologic findings of progressive supranuclear palsy and includes two new case reports. Findings in the patients reported here include extensive neuronal loss with reactive gliosis in deep subcortical gray matter such as globus pallidus, subthalamic nuclei, substantia nigra, red nucleus, dentate nucleus, and inferior olives. Neurofibrillary tangles were also noted in thalamus, hypothalamus, striatum, nucleus basalis, locus ceruleus, basis pontis nuclei, midbrain, pontine, and medullary reticular formation as well as in various cranial nerve nuclei

ISSN:0272-846X    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Elevation and intorsion of one eye and synchronous depression and extorsion ot the other eye characterize c half cycle of seesaw nystagmus. Reversal of these movements constitutes the second half cycle, forming the “seesaw”-like movements. Based on analysis of the ocular oscillation characteristics of the cases of seesaw nystagmus reported in the literature, including the two new cases we present we postulate that seesaw nystagmus is another type of ocular oscillation broughi about by an unstable visuovestibular interaction contro system. Nonavailability of retinal error signals to the inferior olivary nucleus essential for vestibuloocular reflex adaptation due to complete chiasmal dissection makes the system less stable. This system instability is further accentuated by the pursuit feedback element. The intaci inferior olivary nucleus-nodulus connections in seesaw nystagmus would explain the 180|Mo phase difference thai distinguishes it from the midline form of oculopalata myoclonus, where these connections are likely disrupted

ISSN:0272-846X    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Unilateral peripheral sixth nerve palsy associated with an ipsilateral postganglionic Horner's syndrome has previously been described. Isolated bilateral sixth nerve palsy due to a pontine hemorrhagic lesion, however, is a rare occurrence. We describe such a case whose only other neurological finding was a unilateral preganglionic Horner's syndrome

ISSN:0272-846X    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Ophthalmoplegia occurs infrequently in herpes zoster ophthalmicus. The third nerve appears to be the most commonly affected and the fourth nerve the least. We describe herein the clinical course of six patients with herpes zoster ophthalmoplegia. Spontaneous recovery occurred in four patients. The pathogenesis and clinical features of this syndrome are described

ISSN:0272-846X    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0272-846X    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Acute multifocal posterior placoid pigment epitheliopathy (APMPPE) is an unusual self-limited retinal disorder that has been associated with various systemic complications. To our knowledge, three prior cases associated with cerebral vasculitis have been described. This article describes a patient with APMPPE and angiographically documented cerebral vasculitis who was notable because of (a) the presence of two different cerebral ischemic events, occurring 1 month apart, and (b) the long latency (3 months) between the onset of ocular symptoms and the second cerebral ischemic event. Recognition of the association between APMPPE and cerebral vasculitis may permit early treatment of CNS involvement and prevention of morbidity

ISSN:0272-846X    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0272-846X    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0272-846X    

出版商:OVID    

年代:1988

数据来源: OVID