A woman in her 40s with a history of plasma cell leukemia presented with 1 month of intermittent headaches followed by a seizure. Results from laboratory studies were notable for a cerebrospinal fluid opening pressure of 28 mm H2O and 8 white blood cells, including 1 atypical plasma cell. Imaging studies revealed confluent bifrontal white matter fluid-attenuated inversion recovery hyperintensities, as well as a contrast-enhancing sellar lesion. The patient underwent a stereotactic biopsy. The differential diagnosis, pathologic findings, and diagnosis are discussed.
Graham MS, Pudusseri A, Helgager J, Narendra DP, De Girolami U, Pinkus GS, Sanchorawala V, Miyawaki E. A Woman in Her 40s With Headache and New-Onset Seizures. JAMA Neurol. 2017;74(4):476-480. doi:10.1001/jamaneurol.2016.2961