A 60-year-old woman presented with 2-week progressive weakness of her 4 extremities with slurred speech and choking. She reported a history of insomnia, hyperplasia of the right mammary glands, and postoperative hysteromyoma. A neurological examination revealed dysarthria, reduced muscle strength of all 4 limbs (grade 4 of 5), bilateral hypertonia, hyperreflexia, and Babinski reflexes without sensory alteration or a sensory level. Her symptoms continuously deteriorated after hospitalization.
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Shi K, Shen J, Yue X. Primary Central Nervous System Lymphoma With Symmetrical Pyramidal Tract Hyperintensity. JAMA Neurol. 2021;78(7):876–877. doi:10.1001/jamaneurol.2021.1165
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