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          - Khalid Alsherbini, Kevin Kapadia, and Justin A Sattin.
- Neurology Department, University of Wisconsin - Madison, 1685 Highland Avenue, Medical Foundation Centennial Building, Madison, WI 53705-2281, USA. kalsherbini@uwhealth.org.
- J Med Case Rep. 2011 Oct 25; 5: 525.
 IntroductionWe present the case of a patient with midbrain infarction with an unusual clinical presentation, where clinical diagnosis and anatomical localization were valuable tools in deciding treatment.Case PresentationOur patient was a 59-year-old, right-handed Caucasian man with hypertension who presented to our facility with acute diplopia that persisted until he developed complete right-sided ptosis. He also had difficulty walking and coordinating movements of his upper extremities bilaterally, but this was worse on his left side.ConclusionsPlus-minus lid syndrome with ataxia is a rare presentation of midbrain infarction with a unique localization and anatomical description. This case highlights the importance of clinical skills for making a diagnosis in the absence of imaging to confirm the findings. Notes
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