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A 69-year-old white man presented to the emergency department reporting 2 months of progressive bilateral lower extremity weakness, left facial weakness, and diplopia in the setting of a 20.4-kg weight loss over the previous 6 months and new-onset urinary incontinence. Two months prior he had undergone lumbar vertebra 3–sacra vertebra 1 lumbar laminectomies performed for symptomatic spinal stenosis. Despite this, his leg weakness worsened. He denied headaches, fevers, cough, risk factors for immunosuppression, or travel outside of the northwestern United States.
Vargas TC, Thomas RL, Erickson JC. Leptomeningeal Enhancement in a Patient With Progressive Cranial Neuropathies and Lumbosacral Radiculopathies. JAMA Neurol. 2016;73(3):345-346. doi:10.1001/jamaneurol.2015.3965