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Clinical Reasoning: A 74-Year-Old Woman Presenting With Monocular Ptosis and Binocular Diplopia
Zhenghui Liu1, Wei Wei Zhang1, Piaoyu Dai1
1From the Departments of Neurology (Z.L., X.L., L.S., Y.-B.L.), Radiology (W.W.Z.), and Nephrology (P.D.), Xiangya Hospital, National Clinical Research Center for Geriatric Disorders (L.S.), and Engineering Research Center of Hunan Province in Cognitive Impairment Disorders (L.S.), Central South University, Changsha; Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases (L.S.), Changsha; Key Laboratory of Hunan Province in Neurodegenerative Disorders (L.S.), Central South University, Changsha; and Key Laboratory of Organ Injury (L.S.), Aging and Regenerative Medicine of Hunan Province, Changsha, China.
Abstract:
A 74-year-old woman presented with acute-onset right ptosis and binocular diplopia. CT scan showed low-density lesions in the bilateral basal ganglia and adjacent to lateral ventricles. Intracranial aneurysm was not detected. This case highlights the importance of neurologic localization of ophthalmoplegia based on physical examination and the microanatomy of the oculomotor nerve.
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