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Rapid-onset flaccid paraplegia caused by multiple myeloma dumbbell tumour
  1. Curtis Osborne1,
  2. Simon Stallworthy2,
  3. Jane Evanson3,
  4. Richard Sylvester4,
  5. Alastair J Noyce5
  1. 1Acute Medicine at Charing Cross Hospital, London, UK
  2. 2Acute Medicine at Whipps Cross Hospital, Barts Health NHS Trust, London, UK
  3. 3Department of Neuroradiology, Barts Health NHS Trust, London, UK
  4. 4UCL Institute of Neurology, London, UK
  5. 5Reta Lila Weston Institute for Neurological Studies, UCL Institute of Neurology, London, UK
  1. Correspondence to Dr Alastair Noyce, Reta Lila Weston Institute for Neurological Studies, UCL Institute of Neurology, London WC1N 1PJ, UK; a.noyce{at}ucl.ac.uk

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Case report

A 43-year-old female Ghanaian office cleaner presented to the emergency department with a 2-day history of progressive, ascending lower limb weakness, with sensory disturbance and urinary retention. There were 2 weeks of non-specific, intermittent back pain, but she had been previously well. She was a lifelong non-smoker and did not drink alcohol. On examination, she had a left Horner's syndrome but the cranial nerves and upper limbs were otherwise normal. In the lower limbs, power was absent in all muscle groups, with areflexia and hypotonia. There was patchy sensory loss but no clear sensory level. Cardiovascular, respiratory and abdominal examinations were normal.

Initial laboratory results found microcytic …

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