An 18-year-old woman presented to Lahey Medical Center with 2 weeks of intermittent diplopia, nausea and headache.
Two weeks earlier, she had experienced acute onset binocular diplopia with horizontal and vertical double images. The episode was accompanied by severe nausea, headache, dizziness and photophobia. After 30 minutes, she experienced complete resolution of all symptoms. One week later, she had a similar episode that lasted for 10 minutes before resolving. Her third episode occurred 2 days before presentation and prompted a visit to the emergency department at an outside hospital. She