The relatively rare syndrome of acquired ocular motor apraxia is characterised by difficulty in initiating saccades to command and to visual targets, usually in all directions.¹

Case report

Our patient was a 52 year old left handed and non-literate man. He was admitted to a local hospital with the complaint of acute and persistent thoracic and epigastric pain radiating to his back. Five days later he developed acute loss of consciousness and was sent to our hospital.

Blood pressure was 170/100 mm Hg from the right arm and 160/100 mm Hg from the left, the right femoral artery was pulseless, and the epigastrium was painful on palpation. He was stuporose, disoriented, and his cooperation was limited to simple commands only. He had bilateral ptosis with his eyes fixed in the primary position. Convergence was absent. However, an oculocephalic reflex could be elicited in both vertical and horizontal directions. His left nasolabial sulcus was somewhat reduced. He had paresis of both his arms and his left leg, while the motor strength in his right leg was almost completely normal. Hoffman and Babinski signs were positive on the left side, with hyperreflexia. The tendon reflexes were normal on the right side and no pathological reflexes were elicited. He had urinary incontinence.

On the third day of admission he appeared apathetic. Although his thinking was slowed, and his affect was flattened, he could answer simple questions and obey simple commands. He still had difficulty in understanding complex orders. His ptosis had resolved …