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When a bruise is not just a bruise
  1. Su-Yin Lim,
  2. Champika Gunawardhana,
  3. Mark Lawden
  1. Department of Neurology, Leicester General Hospital, Leicester, UK
  1. Correspondence to Dr Su-Yin Lim, Department of Neurology, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK; suyinlim{at}

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A 58-year-old woman developed binocular diplopia after violently retching during an episode of gastroenteritis. She experienced discomfort over the left lower eyelid and then developed diplopia, maximal on left gaze.

On examination, there was restriction of left eye abduction. Visual acuity was normal. Her pupils were equal and reactive. She had no ptosis or proptosis, and fundoscopy was normal. An unenhanced CT scan of head was reported as normal and she was discharged home with a diagnosis of an idiopathic left sixth cranial nerve palsy. Two …

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