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September 1979

Primary Cerebral Lymphoma Mimicking Multiple Sclerosis

Author Affiliations

Department of Neurology
Department of Pathology The New York Hospital—Cornell Medical Center 525 E 68th St New York, NY 10021

Arch Neurol. 1979;36(9):598. doi:10.1001/archneur.1979.00500450092026

To the Editor.—  We have encountered a case of primary cerebral lymphoma whose initial course resembled that of multiple sclerosis. This case was similar to the first case reported by Williams et al in the Archives (36:206-220, 1979).

Report of a Case.—  In 1974, truncal ataxia followed by horizontal nystagmus developed in a middle-aged man. The results of initial diagnostic studies, including a fourvessel cerebral arteriogram, pneumoencephalogram, and the results of CSF evaluation, were normal. The neurologic signs resolved with treatment with adrenocorticotropic hormone (ACTH). During the next three years, the patient had three subsequent exacerbations of ataxia and nystagmus, each with severe but incomplete resolution with treatment with ACTH. In 1976, a computerized tomographic (CT) scan was normal. In December 1977, confusion, dysarthria, horizontal and vertical gaze nystagmus, and truncal ataxia developed in the patient. Again, his condition was treated with ACTH with transient neurologic resolution. The neurologic

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