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March 1946

DIVERGENCE PARALYSIS ASSOCIATED WITH TUMOR OF THE BRAIN

Author Affiliations

NEW YORK

From the Division of Neuropsychiatry, Montefiore Hospital, and the Department of Neurology Columbia University College of Physicians and Surgeons.

Arch NeurPsych. 1946;55(3):232-235. doi:10.1001/archneurpsyc.1946.02300140063003
Abstract

DIVERGENCE paralysis associated with cerebral tumor has been reported in only 5 cases, 2 of which were verified. Straub1 reported the case of a 20 year old woman with bilateral papilledema, involvement of the left trigeminal, facial and acoustic nerves and bilateral nystagmus. The author's diagnosis was "tumor" of the middle fossa. Howard2 described the case of a woman aged 71 who had had a carcinoma of the breast removed five years previously. She complained of diplopia for two months prior to the examination, which revealed divergence paralysis. Multiple areas of destruction of the bony cranial vault and the sella turcica were observed in the roentgenograms. The diagnosis was "metastasis of the carcinoma to the supposed divergence center." Holden3 mentioned seeing divergence paralysis in a case of "mid-brain tumor" but gave no clinical data. These 3 cases were not verified by operation or necropsy. Lippmann4 recently

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