A 29-year-old man developed vertigo, diplopia, confusion, and spastici
ty. Brain biopsy revealed multifocal microinfarcts. Bilateral hearing
loss and retinal microangiopathy were also noted. Deficits were stable
2 years after onset. Repeated neuropsychological testing was suggesti
ve of diffuse cerebral dysfunction, with likely prominent involvement
of reciprocal diencephalic-cortical projections.