An elderly patient presents with generalized poor eye movements but no pertinent symptoms; what is your differential diagnosis?
Analysis
Watch this video to see the patient's versions.
This patient was noted to have bilateral restriction of extraocular movements in many areas of gaze. The patient, however, did not complain of diplopia.
The patient was diagnosed with chronic progressive external ophthalmoplegia.
In the video discussion, Dr. Paul Freund will
- Identify causes of bilateral symmetric restriction of extraocular movements
- Review the presentation of ptosis that is recurrent (even post ptosis repair surgery)
- Review the importance of asking about family history when presenting with bilateral restrictions in extraocular motility
Neuro Coach Tip
Patients with generalized poor EOM are often asymptomatic from double vision due to gradual onset of symptoms and ability to compensate with head movements.
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