Ophthalmic manifestations of bilateral non-occipital cerebral lesions

Abstract

Twelve patients are described with neuro-ophthalmic symptoms resulting from bilateral cerebral lesions in areas other than the occipital lobes. The symptoms and signs are categorized as follows: Group L-Those showing predominant disturbances in visual object recognition (visual agnosia) and disturbances of visual spatial localization. Group IIa.-Those having defects in voluntary control of eye movements (ocular motor apraxia). Group Ilb.-Those with persistent palsies of conjugate gaze. Although these symptoms may be present to some extent with unilateral lesions, they are much more profound and less able to be compensated with bilateral lesions. The evidence in the present cases suggests a biparieto-temporal localization for the lesions causing visual agnosia, disturbances of spatial localization, and ocular motor apraxia, and a more frontal localization for the lesions causing prolonged paralysis of conjugate gaze.