A 55-year-old diabetic man presents with 2 days of 

severe right supraorbital pain. Examination reveals 

complete right ptosis and a 5-mm fixed pupil, with 

inability to move the eye vertically or inward. Outward 

movement is spared. The left eye is normal as is the rest 

of the examination. The most likely diagnosis is: 

A 36-year-old surgical resident presents to the emer- 

gency room with "trouble walking." Over the last 2 

weeks he has experienced tingling of his toes. His walk- 

ing has changed over the past few days. His examina- 

tion is entirely normal except that he has no reflexes. 

He is discharged from the ER with the diagnosis of "tin- 

gling." He returns to the ER 48 hours later with inabil- 

ity to walk up or down stairs and cannot stand on his 

toes or heels. There is no significant sensory loss, no 

reflexes, normal bowel and bladder function, and nor- 

mal sensation. Pertinent history to elicit would be: 

A 20-year-old college sophomore is brought to clinic by 

his parents for concerns regarding depression. He is 

having trouble completing his schoolwork. His parents 

report that his personality has changed and that he has 

become more withdrawn from his friends over the past 

year. There is no family history of depression or psychi- 

atric illness. On examination, he is a well-developed 

young man with slight slurring of his speech and a left 

arm tremor. His laboratory testing shows mild LFT ele- 

vations. The test most likely to yield his diagnosis is: 

A 28-year-old female has a throbbing, unilateral 

headache three times a month. It occurs suddenly, per- 

sists for 2 days, and sometimes causes her to miss work. 

She has been having the headaches intermittently for 6 

years and associates them with lack of sleep and stress. 

What type of headache is this? 

A 68-year-old man with a history of hypertension and 

tobacco use presents with an episode of loss of vision in 

the right eye lasting approximately 2 minutes. His eye 

examination is now normal. On further questioning, 

he noted a spell of left face numbness and slurred 

speech 2 weeks earlier. His neurologic examination is 

normal. The most likely cause of his symptoms is: