A 60-year-old female comes to your office complaining of double vision when looking straight ahead (see image). This started 10 days prior after a brief left, retro-orbital headache. The headache has since resolved. She has a history of type 2 diabetes. She has no history of any injury. Her left pupil was dilated and during normal gaze, there was a slight ptosis on the left side (not visible below)
Which of this patient's cranial nerves is malfunctioning:
The following photo collage (image 1) shows the effects of a right-sided CN III palsy (different from the above patient, who has a left-sided CN III) during extra-ocular movement testing:
Reference:
Guluma K. “Diplopia.” Rosen’s Emergency Medicine: Concepts and Clinical Practice, 9th Ed. Elsevier 2018: 160-168.
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