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