FORCED CONJUGATE UPWARD MOVEMENTS OF THE EYES

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Abstract
In November, 1923, my attention was first directed to an extraordinary eye symptom which the ophthalmologists assured me was known to them only as an hysterical symptom. A patient was discharged from his job as street-car conductor because his eyes had "turned up" and he "could not get them down again." A few days later another patient came into our outpatient department with her eyes turned up and to the left, with curious nystagmoid movements, and she "could not turn them down." The ophthalmologists examined her immediately afterward and assured us that no objective findings could account for the difficulty. A careful search of the literature at that time failed to reveal any reference to such eye muscle spasms. Both cases were clearly postencephalitic Parkinson syndromes. The fact that both cases had developed without acute febrile attacks and were recognized only after the full development of the rigidity with masklike

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