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https://www.facebook.com/61562429756809/posts/122110200458414325/
25/09/2024

https://www.facebook.com/61562429756809/posts/122110200458414325/

65 Y/O male has sudden painless horizontal diplopia aggravated on left gaze.
There are no neurological or systemic symptoms, nor the patient has H/O trauma, HTN/DM.
There is no ptosis, pupil are equal in size, reactive to light and convergence.
Motility exam shows limitated adduction of the right eye.
Saccades of left MR are brisk for small amplitudes but absent for large amolitude saccades.
Brain MRI is normal.
What is diagnosis and how to proceed in this case?

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