CEREBRAL OCULAR WHIPPLES-DISEASE - A 62-YEAR ODYSSEY FROM DEATH TO DIAGNOSIS

A 47-year-old white man with dementia, supranuclear ophthalmoplegia, a nd myoclonic ocular and facial jerks died in 1931. The case report in 1936 by Ford and Walsh diagnosed encephalitis. In 1993, we made a clin ical diagnosis of Whipple's disease on the basis of the 1936 publicati on. We restudied the pathologic material and found, in addition to ext ensive encephalitis, PAS-positive material in only the eye, brain, spi nal cord, and pituitary. Electron microscopy demonstrated free and int racytoplasmic microorganisms in the eye and brain. We review the histo ry of cerebral ocular Whipple's disease and the implications from this case, which occurred before the development of antibiotics.