On optic neuritis in intracranial disease / by J. Hughlings Jackson.
- John Hughlings Jackson
- Date:
- 1881
Licence: Public Domain Mark
Credit: On optic neuritis in intracranial disease / by J. Hughlings Jackson. Source: Wellcome Collection.
Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)
13/36 page 9
![The patient is told to look at the end of his nose, or at his hand held near his face. The Argyll-Eobertson con- dition was as manifest in these two amaurotic patients as in any case of tabes dorsalis, without optic atrophy, I have seen.] Section II.—Clinical Facts. Optic neuritis is usually double—in physicians' practice, nearly always. I have seen but two cases of intracranial disease (proved post-mortem, I mean) in patients who had uniocular neuritis. In each case there was a tumour of the opposite cerebral hemisphere, and in each hemiplegia of the same side as the neuritis. Both eyes from one of the patients were examined microscopically by Dr. Hermann Pagenstecher, of Wiesbaden. The left eye, on the side of the tumour, was found by him to be normal, as it had been declared to be during the patient's life.* These cases are very exceptional. It is notorious that tumour of but one cerebral hemisphere, nearly always, if it produces optic neuritis, produces double optic neuritis, and, what is more to the point, the neuritis begins nearly at the same time on the two sides; it may be unequal in degree ; there is often great difference in the sight, at least. What does uniocular optic neuritis signify ? Has it been found in cases of tumour of one cerebral hemisphere which had not produced any localising symptoms ? I put this question for clinical reasons, and with regard to the next—Does uniocular neuritis result from pressure or involve- ment of the optic nerve ? Stating the last two questions clinically—If a patient has uniocular optic neuritis with severe headache and no ordinary localising symptoms, how are we to tell whether he has disease at the base or in one cerebral hemisphere ? Does uniocular optic neuritis ever result from local organic disease in the cerebellum ? I have not seen this, although I have often seen it double from disease of different parts of the cerebellum. Can we distin- guish uniocular neuritis resulting from tumour or aneurism in the orbit or near the cavernous sinus inside the cranium, from uniocular neuritis from disease of the great centres— of course, I mean apart from there being palsies of parts supplied by nerves entering the orbit ? Is there anything in the degree of swelling to be relied on ? I feel convinced that the diagnostic value of optic neuritis is not different whether sight be good or lost. My own *^ Hoyal Lond. Ophth. Hosp. Rep., November, 1871.](https://iiif.wellcomecollection.org/image/b21637350_0013.jp2/full/800%2C/0/default.jpg)
