• Xue Wang, Yang Yu, Wenxia Zhang, and Hongmei Meng.
• Department of Neurology and Neuroscience Center, First Hospital of Jilin University, Changchun, Jilin, China.
• Medicine (Baltimore). 2018 Jun 1; 97 (24): e11150.

RationalePatients rarely display eye movement dysfunctions as the primary symptom in transient ischemic attack.Patient ConcernsA 58-year-old patient with a history of hypertension and smoking presented with a 1-month history of paroxysmal exotropia of the left eye and double vision. No obvious abnormality was found in imaging examination and the patient ignored his symptoms. Eleven days later, the symptoms worsened and brain imaging provided an abnormal signal involving the left cerebellar hemisphere and the bilateral occipital lobe.DiagnosesBased on the clinical manifestation and imaging findings, an acute cerebral infarction was diagnosed.InterventionsThe patient was subjected to antiaggregation therapy.OutcomesOne week later, the symptom of paroxysmal exotropia of the left eye was no longer present.LessonsAtypical symptoms of transient ischemic attack are easy to be overlooked. Early diagnosis and timely treatments are keys to reverse the neurological symptoms and can be highly beneficial for patients with this condition.

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