A 74-year-old retired male scientist reported visual misperceptions over 3 weeks. These included seeing objects as if through a camera lens, fluctuating brightness despite no change in ambient light, photopsia, light sensitivity, objects appearing closer than they were, horizontal diplopia, altitudinal field loss and ‘looking from the inside outward’. When walking, he felt the floor curved upwards and the world moved around him abnormally. He reported multidirectional falls. His family reported that he was less proactive and had developed episodic memory loss over the preceding 2 months. He had a history of axonal neuropathy, pernicious anaemia and degenerative spinal disease. There was no history of sleep disorder, psychosis or anosmia and no significant family history. On examination, he had an inferior visual field defect and reported bilateral horizontal diplopia on eye movements but without objective ophthalmoplegia. There was no muscle wasting or fasciculations. Tone and strength were normal throughout. He had depressed reflexes in keeping with longstanding neuropathy. He had slight bradykinesia and an intention tremor. He was hesitant when walking but stride length and arm swing were normal. There was no gait ataxia. Cognitive testing showed deficits in attention, memory and …

中文翻译：

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视觉误解

一位 74 岁的退休男性科学家报告了超过 3 周的视觉误解。这些包括通过相机镜头看到物体，尽管环境光没有变化，但亮度波动，光感，光敏感度，物体看起来比实际更近，水平复视，高度场损失和“从内向外看”。走路的时候，他感觉地板向上弯曲，周围的世界都在不正常地转动着。他报告了多向跌倒。他的家人报告说他不那么积极主动，并且在过去 2 个月内出现了发作性记忆丧失。他有轴索性神经病、恶性贫血和退行性脊柱疾病的病史。没有睡眠障碍、精神病或嗅觉丧失病史，也没有明显的家族史。考试时，他有一个较差的视野缺损，报告眼球运动时双侧水平复视，但没有客观的眼肌麻痹。没有肌肉萎缩或肌束震颤。语气和力量自始至终都正常。与长期存在的神经病相一致，他的反射抑制了。他有轻微的运动迟缓和意向性震颤。他走路时犹豫不决，但步幅和手臂摆动正常。没有步态共济失调。认知测试显示注意力、记忆力和… 他走路时犹豫不决，但步幅和手臂摆动正常。没有步态共济失调。认知测试显示注意力、记忆力和… 他走路时犹豫不决，但步幅和手臂摆动正常。没有步态共济失调。认知测试显示注意力、记忆力和…