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Ocular Signs After Stereotactic Lesions in the Pallidum and Thalamus

Ocular Signs After Stereotactic Lesions in the Pallidum and Thalamus Abstract This is a report of the occurrence of nystagmus retractorius, inferior quadrantanopia of optic tract or geniculate origin, and paresis of conjugate gaze, following localized stereotactic lesions in the central nervous system of man. These ocular phenomena were observed after the lesions were placed in the region of the pallidum or thalamus for the relief of tremor and rigidity in extrapyramidal diseases and for the relief of intractable pain. Report of Cases Case 1. —This 72-year-old white woman developed intractable postherpetic neuralgia following herpes zoster ophthalmicus on the right in August, 1958. Protamine, x-ray therapy, avulsion of the right supraorbital nerve, and undermining of the affected skin failed to produce relief. Because of persistence of the pain, she was admitted to Duke Hospital in July, 1960, for stereotactic thalamotomy.Neurological examination revealed a complete anesthesia in the distribution of the first division of the right trigeminal nerve; otherwise, it was References 1. Bertrand, C., and Martinez, N.: An Apparatus and Technique for Surgery of Dyskineasias , Neurochir. 2:36, 1959. 2. Cogan, D. G.: Neurologic Significance of Lateral Conjugate Deviation of the Eyes on Forced Closure of the Lids , Arch. Ophth. 39:37 ( (Jan.) ) 1948.Crossref 3. Smith, J. L.; Gay, A. J., and Cogan, D. G.: The Spasticity of Conjugate Gaze Phenomenon , A.M.A. Arch. Ophth. 62:694 ( (Oct.) ) 1959.Crossref 4. Smith, J. L.; Zieper, I.; Gay, A. J., and Cogan, D. G.: Nystagmus Retractorius , A.M.A. Arch. Ophth. 62:864 ( (Nov.) ) 1959.Crossref 5. Foix, C., et al.: Obliteration de l'artere choroidienne anterieure; ramollissement de son territoire cerebral: hemiplegie; hemianesthesie; hemianopsie 6. Morello, A., and Cooper, I. S.: Visual Field Studies Following Occlusion of the Anterior Choroidal Artery , Am. J. Ophth. 40:796 ( (Dec.) ) 1955. 7. Nashold, B. S., Jr.: Cholinergic Stimulation of Globus Pallidus in Man , Proc. Soc. Exper. Biol. & Med. 101:68 ( (May) ) 1959. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Ocular Signs After Stereotactic Lesions in the Pallidum and Thalamus

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Publisher
American Medical Association
Copyright
Copyright © 1961 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1961.01840020534012
Publisher site
See Article on Publisher Site

Abstract

Abstract This is a report of the occurrence of nystagmus retractorius, inferior quadrantanopia of optic tract or geniculate origin, and paresis of conjugate gaze, following localized stereotactic lesions in the central nervous system of man. These ocular phenomena were observed after the lesions were placed in the region of the pallidum or thalamus for the relief of tremor and rigidity in extrapyramidal diseases and for the relief of intractable pain. Report of Cases Case 1. —This 72-year-old white woman developed intractable postherpetic neuralgia following herpes zoster ophthalmicus on the right in August, 1958. Protamine, x-ray therapy, avulsion of the right supraorbital nerve, and undermining of the affected skin failed to produce relief. Because of persistence of the pain, she was admitted to Duke Hospital in July, 1960, for stereotactic thalamotomy.Neurological examination revealed a complete anesthesia in the distribution of the first division of the right trigeminal nerve; otherwise, it was References 1. Bertrand, C., and Martinez, N.: An Apparatus and Technique for Surgery of Dyskineasias , Neurochir. 2:36, 1959. 2. Cogan, D. G.: Neurologic Significance of Lateral Conjugate Deviation of the Eyes on Forced Closure of the Lids , Arch. Ophth. 39:37 ( (Jan.) ) 1948.Crossref 3. Smith, J. L.; Gay, A. J., and Cogan, D. G.: The Spasticity of Conjugate Gaze Phenomenon , A.M.A. Arch. Ophth. 62:694 ( (Oct.) ) 1959.Crossref 4. Smith, J. L.; Zieper, I.; Gay, A. J., and Cogan, D. G.: Nystagmus Retractorius , A.M.A. Arch. Ophth. 62:864 ( (Nov.) ) 1959.Crossref 5. Foix, C., et al.: Obliteration de l'artere choroidienne anterieure; ramollissement de son territoire cerebral: hemiplegie; hemianesthesie; hemianopsie 6. Morello, A., and Cooper, I. S.: Visual Field Studies Following Occlusion of the Anterior Choroidal Artery , Am. J. Ophth. 40:796 ( (Dec.) ) 1955. 7. Nashold, B. S., Jr.: Cholinergic Stimulation of Globus Pallidus in Man , Proc. Soc. Exper. Biol. & Med. 101:68 ( (May) ) 1959.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Apr 1, 1961

References