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34 year old man with headache, vertigo, clumsiness, and unsteady vision
Digital Journal of Ophthalmology 1996
Volume 2, Number 1
August 14, 1996
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Melanie Ryan-Graham, MD | Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
Simmons Lessell, MD | Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
The patient described HAVING had headaches since childhood, which characteristically got worse with activities such as coughing, sneezing, choking, postural changes, and Valsalva, and which were sometimes associated with vertigo. The patient reported being so clumsy that his friends call him "Tanglefoot". During an episode of sneezing with vertigo 3 years prior to presentation, he fell to the floor and had difficulty arising. At that time, he was evaluated with a head CT and ateriogram, which were found to be unremarkable. The headaches were described as occipital in location, with an associated neck pain that prompted him to see a chiropracter. During the year prior to presentation, a bidirectional vertical oscillopsia, as described above, developed.

PMHx: Non contributory
Meds: None
SHx: Non contributory
FHx: Non contributory