A 63-year-old man presented six days after the sudden onset of horizontal double vision. His left eye became divergent two days later. On initial examination he had bilateral internuclear ophthalmoplegia with weakness of adduction and abducting nystagmus. Convergence was weak but there were no other neuro-ophthalmic signs. Constitutional signs included confusion and unsteadiness on his feet. A provisional diagnosis of arteritis was made. His ESR was 92 mmlh and a superficial temporal artery biopsy confirmed the diagnosis of giant cell arteritis. After two weeks or oral prednisolone his eye movements returned to normal. There have been no further relapses.This would appear to be a unique presentation of giant cell arteritis. The causes of internuclear ophthalmoplegia are discussed along with a review of the ocular and neuro-ophthalmic signs of giant cell arteritis.

Demographic, clinical and physical information was obtainedfrom 200 volunteers who had Parkinson's disease PD). The clinical history revealed minimal social and psychological impairment. Physical difficulties such as mobility and restless legs were reported as the most troublesome symptoms of PD. A disease seventy score was calculated by the addition of the ratingsfrom the physical examination to a scaled score obtainedfrom a foot tapping exercise. Over halfof the sample had disease seventy scores which were less than or equal to the mean of the entire sample. Functional disability was measured by the Sickness Impact ProJile (SIP) and the highest dysfunction scores were in the areas of recreation and oastimes, alemess behaviour, communication and home management. Functional disability was significantly positively correlated with age and duration of illness.

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