Myasthenia with persistent right lateral rectus paresis. Orbits: The right lateral rectus and other extraocular muscles are unremarkable. The bilateral orbital fat, globes, optic nerves, and lacrimal glands are intact bilaterally. There is no evidence of intraorbital tumors. Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are mild scattered cerebral white matter T2 hyperintense foci bilaterally. The brainstem and cerebellum are unremarkable. The cavernous sinuses are intact. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull and scalp soft tissues are grossly unremarkable. There is mild mucosal thickening in the anterior ethmoid sinuses.
1. The right lateral rectus and other extraocular muscles are unremarkable. 2. No evidence of intracranial hemorrhage, mass, or acute infarct. 3. Mild scattered cerebral white matter T2 hyperintense foci bilaterally are nonspecific, but may represent chronic small vessel ischemic disease. 