Approach to differentiating lesions (brainstem) Quiz: Ace Your Exams
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A 42-year-old woman presents to the emergency department with a severe headache and new-onset horizontal double vision that began this afternoon. She has no prior history of headaches. Her past medical history is noncontributory, and she takes no medication. Her temperature is 37.0°C (98.6°F), pulse is 84/min, respirations are 14/min, blood pressure is 120/80 mmHg, and oxygen saturation is 100% on room air. On physical examination, the patient is in acute distress due to pain. There is ptosis of the right eye, which is deviated downward and laterally at rest. The right eye is unable to adduct or look upward. Strength and sensation are normal throughout. Which of the following additional physical examination findings is most likely to be present?
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