Isolated bilateral oculomotor nerve palsies due to a midbrain cavernous malformation

A 41-year-old woman in good health developed diplopia during work on the day of admission. She denied any weakness, headache or change in mental status. Her blood pressure was normal on admission. Physical examination found bilateral ptosis with a limitation in elevation in both eyes. The adduction and depression were impaired on the left eye. The left pupil was dilated and non-reactive (figure 1). The remaining neurological examination was unremarkable. The blood tests showed a normal full blood count and clotting profile. CT of the …