25 year old women comes to doctor because of headaches, nausea and vomiting. No hx of alcohol or tobacco usage. No medications. Neurological examination shows pupils have minimal reaction to light but do constrict during accommodation. She is unable to look upward past horizontal plane but has full conjugate eye movements in other directions. She is unable to converge. Visual field tesitng shows no abnormalities. 1. What diagnosis are you most likely suspecting? 2. Why do you suspect this?

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Neurology is the branch of medicine that focuses on the study, diagnosis, and management of conditions affecting the nervous system.


1. 25 year old women comes to doctor because of headaches, nausea and vomiting. No hx of alcohol or tobacco usage. No medications. Neurological examination shows pupils have minimal reaction to light but do constrict during accommodation. She is unable to look upward past horizontal plane but has full conjugate eye movements in other directions. She is unable to converge. Visual field tesitng shows no abnormalities. 1. What diagnosis are you most likely suspecting? 2. Why do you suspect this?