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The pretectal syndrome

206 patients

Department of Neurology, Los Angeles County/University of Southern California Medical Center, Los Angeles, CA.

The pretectal syndrome occurred in 2.3% of patients personally examined over an 18-year period. The symptoms were nonspecific, but the signs (abnormal pupils in 198 patients, vertical gaze limitation in 180, disjunctive horizontal eye position in 90 and vertical in 79, lid retraction in 83, and convergence-retraction nystagmus in 71) were exquisitely localizing. The etiology, skewed by the local prevalence of cysticercosis, was hydrocephalus in 80 patients, stroke in 53, and tumor in 45. The importance of timely diagnosis was underscored by the relatively good prognosis of many patients.

Address correspondence and reprint requests to Dr. James R. Keane, 1200 North State Street, Los Angeles, CA 90033.

Received July 10, 1989. Accepted for publication in final form September 1, 1989.

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