07-13-2011, 04:49 PM
A 64 year old woman is evaluated in the emergency room for acute development of double vision and droopy left eyelid. She denies any fever or headache. Her past medical history is significant for diabetes mellitus and hypertension. On physical examination, she is afebrile and her blood pressure 132/88 mm Hg. Head and neck examination reveals ptosis of the left eyelid. Pupillary light reflex is intact . She can not adduct her left eye past the midline. The left eye is deviated downwards and laterally as shown in the picture below. There is no sensory loss on her face and the function of her other facial muscles are intact. Power is normal in all her extremities and deep tendon reflexes are intact. Which of the following is the most likely cause of her symptoms?
image : http://usmlestep3blog.com/2011/07/13/que...-week-238/
Which of the following is the most likely cause of her symptoms?
A) Ophthalmoplegic migraine
B) Diabetic Mono-neuropathy
C) Posterior communicating artery aneurysm
D) Weber syndrome
E) Lateral medullary syndrome
Which of the following is the most likely eventual outcome of her condition?
A) Sub-arachnoid hemorrhage
B) Spontaneous resolution
C) Cerebellar ataxia
D) Persistent visual deficits
E) Aneurysmal Rupture
image : http://usmlestep3blog.com/2011/07/13/que...-week-238/
Which of the following is the most likely cause of her symptoms?
A) Ophthalmoplegic migraine
B) Diabetic Mono-neuropathy
C) Posterior communicating artery aneurysm
D) Weber syndrome
E) Lateral medullary syndrome
Which of the following is the most likely eventual outcome of her condition?
A) Sub-arachnoid hemorrhage
B) Spontaneous resolution
C) Cerebellar ataxia
D) Persistent visual deficits
E) Aneurysmal Rupture