25th June 2023

A 32-year-old lady who is 28 weeks pregnant presents with a sudden onset headache, blurred vision, nausea, and diplopia

A 32-year-old lady who is 28 weeks pregnant presents with a sudden onset headache, blurred vision, nausea, and diplopia. She has no previous past medical history but still smokes 10 cigarettes a day, although she avoids alcohol. On examination, she has no change in visual fields and no appreciable change in visual acuity. You note that she has maximal diplopia on looking to her right and note that she has difficulty abducting her right eye. She is otherwise neurologically intact. Fundoscopy reveals no evidence of papilloedema. A plain CT head finds no appreciable bleeds, infarcts, or space occupying lesions.

Which is the most appropriate initial treatment considering her likely condition?