ABSTRACT
In the following paper we report a case of inverted vision resulting from an injury, whose accompanying symptoms may permit a detailed explanation of the complex disordered mechanisms.
The woman involved, now 60-years-old, was until Feb. 5, 1941 free of any central nervous system or visual disorder. On the night of Feb. 6, she slept uneasily and repeatedly awoke because she was plagued by a violent ringing in her ear, which she attributed at first to a gas leak inside the apartment or a storm which had broken out. She wanted to sit up in bed, but she experienced nausea and dizziness and finally fell backwards to the left. She called to her brother for help. As he entered and put on the light, something happened which terrified her and caused her to think she was either suffering from a severe eye affliction or had lost her mind. The brother who entered the room seemed to be moving on his head! Upon inquiry, it turned out that he actually was not “moving” on his head but that he appeared to be upside down in the room. The patient also saw the movement of his legs as he walked. It was not merely the brother who seemed to have been turned upside down in the room, but the whole visual space of the patient so that the floor was above and the ceiling below. Moreover, the feeling of her body position was altered and it appeared as if her feet were above and her head below, suspended on her feet so to say. She remembers having wondered not only that she did not fall down from this position, but moreover, having a feeling of being restfully supine. The bed itself was in a position corresponding to the body, following it with a 90° axis reversal. Visual space, however, seemed turned at a 180° angle, both in the same direction from the foot of the bed upwards.
In addition to this phenomenon, in which visual space and the sensation of body position, were affected, there were some other symptoms. The first was an inability to speak. She could only mumble though she understood everything. There was also the sensation that the entire left side of her body felt like fur.
As to the duration of these symptoms, the inverted vision started at 3 AM and lasted until 12 noon, followed by a short period of blurred vision and then normal vision. In the same period or a little earlier, speech was also restored. The dead feeling on her left side partially remains, affecting the left arm and leg. Objects easily fall out of her left hand because of impaired sensation. She walks with difficulty because of altered sensation in her left leg. She is also often afflicted with headaches.
Neurological findings are essentially: increased end position nystagmus to the right (horizontal, rotary). Slight tendency toward lifting the left arm. Slight ataxia of the left limbs. Left hypodiadokokinesis. Absent abdominal wall reflexes. Insecurity on left knee-heel test. Hyperesthesia on the left lateral leg. Gait is insecure and small stepped. The left leg drags a bit; slight tottering to the left. On the Romberg, tottering to the left.
Blood pressure on admission was 150/80, now only 135/80.
Internal findings revealed chronic myocarditis.
In our clinic her overall condition was first observed to show good improvement, but on April 30 she suddenly collapsed during lunch with an outbreak of pallor, sweating and a hardly perceptible pulse. Neurologically there was no change.
