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R C Senelick

Publications and source records attributed to R C Senelick.

10 recordsLinked to original sources

Electromyography.

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Decision Making

Total alleviation of downbeat nystagmus in basilar impression by transoral removal of the odontoid process.

The presence of primary position downbeat nystagmus indicates disease at the cervicomedullary junction where craniovertebral anomalies are commonly encountered. This paper reports a patient whose only symptom was disabling oscillopsia and downbeat nystagmus secondary to basilar impression and Arnold-Chiari malformation. He experienced total resolution of his symptoms following transoral removal of the odontoid process. In the past it was felt that ocular signs and symptoms did not improve with surgery for craniovertebral anomalies. In light of this report, the ocular symptoms of craniovertebral anomalies may be considered indications in themselves for surgical intervention.

Adult

Alexia without agraphia in a left-handed patient with prosopagnosia.

A left-handed patient was studied who had the acute onset of alexia without agraphia, a left homonymous hemianopia, and prosopagnosia. Neurodiagnostic tests including computerized axial tomography and angiography disclosed bilateral lesions in the posterior cerebral hemispheres involving the splenium of the corpus callosum. Neuropsychologic examination indicated marked impairment of facial discrimination, deficient naming and memory of presented visual material, and mild visual agnosia with relative preservation of other cognitive functions. These findings are consistent with a double disconnection syndrome involving disconnection of the dominant angular gyrus and right inferotemporal cortex from their bilateral visual inputs.

Agnosia

"Painless" spinal epidural hematoma during anticoagulant therapy.

Severe back or radicular pain has previously been considered as the earliest and most prominent symptom in spinal epidural hematoma. In the patient described here, a "painless" spinal epidural hematoma developed during anticoagulant therapy. The absence of pain delayed recognition of the lesion and institution of therapy. The absence of pain is distinctively rare, but should not delay appropriate diagnostic procedures when other signs suggest the presence of a spinal epidural hematoma.

Adolescent

"Ping-pong" gaze. Periodic alternating gaze deviation.

A clinicopathologic study of patient with periodic alternating gaze deviation is presented. The patient's eye moved rhythmically and conjugately from one extreme lateral position to the other. A 0.45-cm hemorrhage, found in the midline deep vermis, is thought to have disrupted the neural integrator that holds positions of gaze, resulting in periodic alternating gaze deviation. Three previous cases of periodic alternating gaze deviation are reviewed and illustrate the role of the cerebellum in the control of eye movements.

Cerebellar Diseases