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An elderly lady with collapse
  1. F U Huwez,
  2. U Umasankar,
  3. D Aggarwal
  1. Stroke Unit (Lister Ward), Orsett Hospital, Orsett, Grays, Essex RM16 3EU, UK
  1. Correspondence to:
 Dr Umasankar;

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Answers on p 111.

A 78 year old women was admitted to hospital with collapse and sudden onset left sided hemiplegia and a right sided ptosis. On admission she was drowsy. She had a left hemiplegia and right ptosis. When the right upper eyelid was passively raised, there was a fixed outward deviation of the right eye. Both pupils were of equal size and reacting to light. No diplopia or sensory signs were noted at presentation.


  1. What are the findings in figs 1 and 2?

  2. What is the diagnosis?

Figure 1

Patient with arms raised (reproduced with patient's permission).

Figure 2

Patient's face showing clinical signs (reproduced with patient's permission).

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