Recurrent Headache, Ophthalmoplegia, and Quadriparesis induced by Intracranial Hypertension

ABSTRACT

A 67-year-old man developed intermittent headaches, ophthalmoplegia, loss of consciousness, and hyporeflexic quadriparesis. An examination disclosed bilateral papilledema, constricted visual fields, and elevated intracranial pressure. All these symptoms were well correlated with intermittent high intracranial pressure which represented Lundberg A wave. Repeated lumbar punctures finally revealed metastatic malignant cells from lung cancer. Leptomeningeal metastasis may manifest with various constellations of symptoms.