Congenital disturbances of the ocular muscles occur in the following order of frequency: (a) ptosis, (b) paralysis of the abducens nerve with or without involvement of the facial nerve and (c) complete or incomplete involvement of the third nerve with ptosis. Congenital familial external ophthalmoplegia without ptosis is rare.1 A case of this anomaly associated with involvement of the right side of the pyramidal tract is reported. The interest in this case lies not only in the rarity of the condition but in the clinical data, which point to a better understanding of the etiology of such anomalies.
A. H., a woman aged 22, was admitted to the neurologic clinic of the New York Post-Graduate Medical School and Hospital complaining of "nervousness," a feeling of tension and "generalized fatigability."
The family history revealed that the patient's grandmother was supposed to have been afflicted with "eye trouble." Persons would remark
HELFAND M. CONGENITAL FAMILIAL EXTERNAL OPHTHALMOPLEGIA WITHOUT PTOSIS: WITH A LESION OF THE PYRAMIDAL TRACT. Arch Ophthalmol. 1939;21(5):823–827. doi:10.1001/archopht.1939.00860050107008
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