Pearls and Oy-sters: Ocular motor abnormalities in bilateral paramedian thalamic stroke

Abstract

A 67-year-old right-handed man with hypertension was admitted to a rural hospital with sudden onset of confusion, double vision, and bilateral drooping of the eyelids. He had difficulty walking and altered behavior. He was afebrile and rest of his clinical examination had normal results. He was admitted to the intensive care unit and managed as a suspected krait bite (due to its high prevalence in the area), although there was no history of a snakebite. Forty-eight hours later, the patient was fully oriented. His eye signs were persistent and he was referred to our institution for further evaluation.