Chapter

Case 17

Sarah Pendlebury, Ursula Schulz, Aneil Malhotra and Peter M. Rothwell

in Oxford Case Histories in TIA and Stroke

Published on behalf of Oxford University Press

Published in print January 2012 | ISBN: 9780199539345
Published online November 2012 | e-ISBN: 9780191753251 | DOI: http://dx.doi.org/10.1093/med/9780199539345.003.0120

Series: Oxford Case Histories

Case 17

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A 29-year-old woman with a history of long-standing well-controlled type 1 diabetes mellitus presented with a one week history of horizontal double vision on looking to the left. She had noticed this after waking up one morning. In the preceding 2 weeks the patient had developed an increasingly severe generalized headache, which was particularly noticeable throughout the night and in the morning. She had vomited on several occasions, and she had also been aware of right-sided pulsatile tinnitus. Six weeks previously the patient had been treated for a presumed ear infection. Although her earache had improved, it had never quite settled. The patient denied any associated photo- or phonophobia, neck stiffness, or motor or sensory symptoms. She was feeling well within herself. Clinical examination some days after the onset of the double vision revealed a left sixth nerve palsy and bilateral papilloedema. There was no other neurological deficit.

Chapter.  1180 words.  Illustrated.

Subjects: Neurology

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