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An elderly lady with collapse

Stroke Unit (Lister Ward), Orsett Hospital, Orsett, Grays, Essex RM16 3EU, UK

Correspondence to:
Correspondence to:
Dr Umasankar;
usankar68@hotmail.com

Submitted 19 January 2001
Accepted 27 March 2001

Keywords: crossed hemiplegia; pupil sparing oculomotor palsy; Weber's syndrome

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.

QUESTIONS

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

View larger version (122K): [in this window] [in a new window]   Figure 1 Patient with arms raised (reproduced with patient's permission).

View larger version (155K): [in this window] [in a new window]   Figure 2 Patient's face showing clinical signs (reproduced with patient's permission).

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