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A 62-year-old man with prostate cancer and pulmonary metastases presented with a partial-onset seizure, involving a forced leftward head deviation and tonic limb posturing. He complained of no other symptoms except for diplopia. On examination, there was mild bilateral papilloedema, bilaterally limited ocular abduction, left-sided ataxia and bilateral extensor plantar responses. His medical history included two previous cerebellar infarctions, presumed to be due to cancer-related hypercoagulability and a completely resected cutaneous melanoma.
MR scan of the brain showed multiple cystic and nodular enhancing intraparenchymal lesions, some containing blood …
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed. This paper was reviewed by Simon Kerrigan from Edinburgh.