Seeing but not recognizing

Visual recognition disturbances are caused by lesions that affect visual cortex as well as white matter connections between visual cortex and temporal and parietal cortex. Homonymous visual field defects are often present but do not explain the recognition difficulty. In "alexia without agraphia" (pure alexia), the intact right visual cortex is disconnected from the left parietal language center by a lesion in the splenium. In "prosopagnosia", visual cortex is disconnected bilaterally from temporal cortex. In simultanagnosia, visual association cortex is damaged. The first condition is most commonly caused by left posterior cerebral artery occlusion, the second by bilateral posterior cerebral artery occlusion or head trauma, and the third by watershed infarction, tumors, abscesses, head trauma, leukoencephalopathies and Alzheimer's disease. When such disorders are suspected, the examiner should supplement the routine visual examination with suggested screening maneuvers.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/26251/1/0000332.pd

Opsoclonus-Myoclonus Presenting With Features of Spasmus Nutans

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66540/2/10.1177_088307389501000117.pd

Going For The Jugular

"Paragangliomas are relatively benign neuroendocrine tumors that often arise from the jugular bulb. They are known to present as masses in the neck or with hearing loss, pulsatile tinnitus, and manifestations of lower cranial nerve palsies. Much less recognized is their tendency to cause increased intracranial pressure and papilledema by obstructing jugular venous outflow. Only 7 such cases have been reported, and with minimal ophthalmic documentation.