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To the Editor:
As a follow-up to the Historical Note by McCrory et al.,1 I would like to report a well-studied patient with the “cerebellar seizures of Hughlings Jackson” occurring consequent to intermittent cerebellar tonsillar herniation. This observation supports the contention of Kinnier Wilson that these paroxysmal events are caused by brainstem compression.2
The 48-year-old man was admitted to the hospital on June 7, 1979, with malaise, headache, and fever. He had been treated for cryptococcal meningitis in November 1977. Physical examination was remarkable for a temperature of 101 °F and a soft systolic murmur. The neurologic examination was remarkable for the absence of spontaneous venous pulsations on funduscopy and a mild decrease furrowing of the right nasal labial fold. CT of the head showed only mild ventricular dilatation. Lumbar puncture revealed an opening pressure of >500 mL water, white blood cells 16/mm3 (100% mononuclear), protein 80 mg/dL, glucose 4 mg/dL with a peripheral glucose …
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