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JAMA Neurology Clinical Challenge
March 2016

Leptomeningeal Enhancement in a Patient With Progressive Cranial Neuropathies and Lumbosacral Radiculopathies

Author Affiliations
  • 1 Department of Neurology, Madigan Army Medical Center, Tacoma, Washington
  • 2Madigan Army Medical Center, Tacoma, Washington
JAMA Neurol. 2016;73(3):345-346. doi:10.1001/jamaneurol.2015.3965

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.

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