Diffuse hypertrophy of the cerebellum.

This condition, which has masqueraded under many names, is probably best termed 'diffuse hypertrophy of the cerebellum', though the more recent papers apparently favour the term 'ganglio-cytoma'. Since the initial description of Lhermitte and Duclos (1920) other reports have appeared scattered in the literature. Reviews have been published by Oppenheimer (1955), Courville (1958), and more recently by Hallervorden (1959). The latter described 21 cases but did not include those of Bignami and De Matteis (1956) and of Courville (1958). Further cases have been reported by Courville (1960) and Christian (1961). The total number of cases, including that described below, is thus 26, of which there have been three survivors. complaining of headache, vomiting, and diplopia. She had for many years been subject to bifrontal headache accompanying recurrent attacks of maxillary sinu-sitis, which symptoms were considerably but incompletely relieved by a left Caldwell-Luc operation at the age of 20 years. It was, however, the increasing severity of similar headache over the previous month, quickly followed by the onset of vomiting, which led her to seek medical advice. The vomiting, which was not projectile, occurred only in the mornings and was preceded by nausea immediately on waking. In the three weeks before admission she had experienced intermittent diplopia most marked on looking straight ahead. On further questioning she admitted to brief episodes of neck stiffness over the previous two months and slight occipital headache on the day of admission. Two other interesting and probably significant features were her spontaneous admission that all through her life her left hand had been 'clumsier' than her right without there being any actual ataxia, and the observation of friends that she had been 'generally slowing up' in her duties for three or four months. There were no other notable events in her previous medical history. The family history was likewise of no significance. EXAMINATION The patient was a slim, healthy-looking young woman. Examination of the central nervous system showed her to be fully conscious and orientated, with memory and powers of concentration unimpaired. There was slight bilateral hyposmia and bilateral papilloedema. Visual acuity was Jl in each eye. Ocular movements were full, but there was coarse nystagmus and difficulty in maintaining gaze to the right. Hypoalgesia to pinprick was noted in the territory of the left trigeminal nerve. Examination of the remaining cranial nerves revealed no abnormality. Power and tone in the limbs and trunk were …