Abstract
Antiphospholipid syndrome may be primary or secondary to various autoimmune processes or infection. Neurologic symptoms may result from vascular thrombosis or direct damage to neurons, glial cells and myelin. We report a patient who initially presented with neurologic symptoms, including ophthalmoplegia, and normal brainstem neuroimaging. An underlying infectious endocarditis and antiphospholipid syndrome were not diagnosed until late in the course of her disease.