Abstract
We present a 41-year-old HIV-positive female patient complaining of complete right palpebral ptosis, diplopia, and inability to balance herself. On examination, the right eye was able to move laterally and downwards. The motor exam showed left hemiparesis (4/5) on upper and lower limbs, bilateral Babinski sign with left hemiataxia without the sensory disorder. CT scan and magnetic resonance imaging angiography demonstrated an ischemic infarct on the right paramedian branch of the posterior cerebral artery territory. This patient did not present clinical manifestations of the thalamic lesion. To our knowledge, this is the first reported case of a young patient presenting a unilateral thalamomesencephalic ischemic stroke secondary to HIV vasculitis with bilateral Babinski signs and without thalamic signs in the medical literature.
Highlights
We present a 41-year-old HIV-positive female patient complaining of complete right palpebral ptosis, diplopia, and inability to balance herself
This patient had a vertical one-anda-half syndrome caused by unilateral thalamomesencephalic stroke (TMS)[1]
Here we report a case of a 41-year-old woman with rightsided TMS
Summary
Any further responses from the reviewers can be found at the end of the article Introduction In 2018, Sato et al reported a 62-year-old man presenting with a rare eye movement This patient had a vertical one-anda-half syndrome caused by unilateral thalamomesencephalic stroke (TMS)[1]. Other clinical presentations of TMS include see-saw nystagmus that shows intorsion and elevation of one eye, with synchronous extorsion and depression on the contralateral one, convergence-retraction nystagmus and contraversive ocular tilt reaction probable due to ischemic involvement of the interstitial nucleus of Cajal[27], anisocoria Another author found vertical ocular motor disturbances in the vertical plane and eye movement synkinesis, hypersomnia, and coma as a Figure 1.
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