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This patient presented with an acute oculomotor nerve palsy on the right; the eye points "down and out".
Case Discussion
The lenses are usually seen on MRI and often on CT and can act as a clue to the diagnosis, provided the scan is performed with the patient alert. A sleeping or drowsy patient may have a disconjugate gaze 1. In this case, the palsy was evident clinically; however, no anatomic cause for the palsy could be found.
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