Abstract
In a patient with a history of malignancy, an isolated neurologic sign or symptom may indicate metastasis to the central nervous system. To exclude this possibility, a lumbar puncture should still be performed after a nondiagnostic cranial computed tomography (CT) scan even in the absence of signs of infection. A case is presented of a 59 year-old man recently diagnosed with non-Hodgkin's lymphoma that presented to the Emergency Department (ED) with the sole complaint of diplopia. Examination was unremarkable except for a left abducens nerve palsy. Cranial CT scan was normal but initial cerebrospinal fluid results were suggestive of carcinomatous meningitis, and cytology results later confirmed this diagnosis. A review of diplopia and carcinomatous meningitis is presented, along with a suggested conservative diagnostic algorithm for cancer patients presenting with neurologic signs or symptoms.
Original language | English (US) |
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Pages (from-to) | 351-354 |
Number of pages | 4 |
Journal | Journal of Emergency Medicine |
Volume | 23 |
Issue number | 4 |
DOIs | |
State | Published - Nov 2002 |
Externally published | Yes |
Keywords
- Carcinomatous meningitis
- Diplopia
- Leptomeningeal carcinomatosis
- Leptomeningeal metastasis
ASJC Scopus subject areas
- Emergency Medicine