Clinical Reasoning: A 74-Year-Old Woman Presenting With Monocular Ptosis and Binocular Diplopia

Zhenghui Liu; Wei Wei Zhang; Piaoyu Dai; Xiaoyan Long; Lu Shen; Yue-Bei Luo

doi:10.1212/WNL.0000000000207751

Clinical Reasoning: A 74-Year-Old Woman Presenting With Monocular Ptosis and Binocular Diplopia

Neurology. 2023 Oct 24;101(17):e1753-e1758. doi: 10.1212/WNL.0000000000207751. Epub 2023 Aug 14.

Authors

Zhenghui Liu¹, Wei Wei Zhang¹, Piaoyu Dai¹, Xiaoyan Long¹, Lu Shen¹, Yue-Bei Luo²

Affiliations

¹ From 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.
² From 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. yuebei507@csu.edu.cn.

PMID: 37580165
PMCID: PMC10624488 (available on 2024-10-24)
DOI: 10.1212/WNL.0000000000207751

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.

Publication types

Case Reports

MeSH terms

Aged
Blepharoptosis* / diagnosis
Blepharoptosis* / etiology
Clinical Reasoning
Diplopia / diagnosis
Diplopia / etiology
Female
Humans
Oculomotor Nerve
Ophthalmoplegia* / complications
Ophthalmoplegia* / diagnosis