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Symptoms and Signs – Differential Diagnosis of Vertical Diplopia • Botulism • Brainstem or cerebellar lesions • Dysthyroid orbitopathy (muscle infiltration) • Hydrocephalus • Lymphoma or metastases affecting the orbits • Myasthenia • Myositis or pseudotumor with orbital involvement • Superior oblique palsy • Third nerve palsy • Wernicke’s encephalopathy 
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