The Distal Basilar Artery Thrombosis Presenting as Acute Progressive Ophthalmoplegia in the Ambulatory Setting: a Neuroophthalmologic Emergency

Acute bilateral ophthalmoplegia is a well recognized sign of brainstem dysfunction. In the presence of other neurologic signs or symptoms, the diagnosis and urgency of evaluation and hospital admission is typically obvious. However, occasionally the ophthalmoplegia may be the only or predominant complaint (especially in distal basilar artery thrombosis, called the "top-of-the-basilar" syndrome).