Case 6-1981

Presentation of Case A 32-year-old right-handed man was admitted to the hospital because of an ataxic gait and right-sided weakness. He was well until 15 months earlier, when he became aware of intermittent diplopia during vigorous exercise. Eleven months before entry the diplopia became more persistent, especially at night. Eight months before admission he began to have difficulty in keeping his balance, followed shortly by dysphagia. Four months later he noticed numbness of the left side of the thorax. Two months before entry a physician observed nystagmus on lateral gaze, for which prisms were prescribed. The patient continued to drive . . .