This communication concerns itself with the case history of a patient whose chief permanent morbid manifestations are described in the title, who suffered for long periods of time from violent headache and vertigo, and who was the subject of various temporary disturbances, presumably functional. Except as mentioned incidentally, varieties of exterior ophthalmoplegia other than those which are complete and congenital are excluded from this discussion. The important literature on this subject, thus limited, is reviewed. REPORT OF CASE History.—M. S. P., an American woman, unmarried, aged 44, holding an executive position in an orphan asylum, reported for examination on Oct. 7, 1929. She sought relief from a violent headache and hoped that a recorrection of her high refractive error would improve her visual acuteness, which had been gradually diminishing for the past four years. She was admitted to the hospital of the University of Pennsylvania on October 17,