Spontaneous remission of a third-nerve palsy in meningeal lymphoma.
We report on a patient with spontaneous remission of a third-nerve palsy who was subsequently found to have meningeal lymphoma. Initial magnetic resonance images (MRI) showed bilateral enhancement of the third nerves. Follow-up MRI 7 months later, without treatment, showed complete resolution. One year after initial presentation, the patient developed multiple lumbosacral radiculopathies and examination of a nerve root biopsy specimen disclosed a B-cell lymphoma. Serial cerebrospinal fluid analyses over the previous year showed occasional atypical cells, later found to resemble closely the biopsy cell type. We conclude that meningeal lymphoma may have a protracted course, with spontaneous remission of both clinical and neuroimaging findings.
Galetta
S L
SL
Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia.
Sergott
R C
RC
Wells
G B
GB
Atlas
S W
SW
Bird
S J
SJ
D000368:Aged; D003389:Cranial Nerve Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008223:Lymphoma / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000150:complications*; D009802:Oculomotor Nerve; D010243:Paralysis / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D012075:Remission, Spontaneous