Visual evoked responses (VER) in four cases of occipital apoplexy supplemented perimetric diagnosis with new electrophysiologic parameters. These included diagnosis of (1) optic radiation involvement by delay in the initial VER component; (2) stirate cortical involvement by obliteration of the initial and late VER components; (3) suprastriate involvement by selective loss of the late VER components, and (4) recovery at one or more of the above levels in the visual process by follow-up examination.
A 26-year-old man with a recurrent cerebellar medulloblastoma developed periodic alternating nystagmus. During radiation treatment, a bilateral voluntary horizontal gaze paresis appeared, and the periodic alternating nystagmus was replaced by periodic alternating gaze. Several days later, full eye movements returned, as did the periodic alternating nystagmus which had an identical periodicity to the periodic alternating gaze. The underlying pathophysiology of periodic alternating nystagmus and periodic alternating gaze is discussed.
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