A Text book of Medicine volume 2

Cover A Text book of Medicine volume 2
A Text book of Medicine volume 2
Georges Dieulafoy
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The nuclear affection most frequently remains limited to the extrinsic muscles, the internal musculature being unaffected. The sphincter of the iris and the ciliary muscle respectively continue to react to light and to accommodation.
POLIOENCEPHALITIS 1295 Finally, let us notice the absence of vertigo, of headache, and of every cerebral reaction.
Such is, in broad outline, the aspect of a patient suffering from external ophthalmoplegia .
The features of internal ophthalmoplegia are as follows :
... the pupil is moderately dilated ; it does not react to light or to accommodation. The ciliary muscle is also paralyzed. The patient can no longer accommodate, the punctum proximum being brought forward and confounded with the punctum remotum. Internal ophthalmoplegia may be primary and exist alone, being later accompanied by external ophthalmoplegia. It may be secondary to the latter. Finally, it may appear at the same time as external ophthalmoplegia.
Course — Prognosis. — The course of nuclear ophthalmoplegia, in its chronic form, varies.


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