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Neurolymphomatosis, defined as invasion of cranial nerves and peripheral nerve roots, plexus or nerves by Non Hodgkin's Lymphoma is a very rare clinical entity. We describe a case of 69 years old gentleman, who presented to us with asymmetric, painful sensorimotor polyneuropathy. He was admitted with 2 months history of dry cough, constitutional symptoms, paraesthesias on right side of face along with painful asymmetrical quadriparesis. Nerve conduction studies were sugges- tive of asymmetrical sensorimotor axonal and demyelinating neuropathy. Cerebrospinal fluid ana- lysis revealed mild pleocytosis with raised protein. FDG-PET showed intense uptake in both adre- nals, abdominal lymph nodes, sacral nerve roots and brachial plexus. Fine needle aspiration cyto- logy of adrenal mass revealed evidence of diffuse large B cell Non Hodgkin's Lymphoma. As patient succumbed to illness, an autopsy was done, which revealed diffuse large B cell lymphoma involv- ing adrenals, brachial and lumbosacral plexuses. Our report provides important insights into a rare cause of painful demyelinating multiple mononeuropathy and emphasises on increasing role and diagnostic utility of PET imaging in evaluation of patients presenting with multiple mononeu- ropathy, especially with regards to paraneoplastic or neoplastic causes such as lymphoma. * Corresponding author.

Background Leptospirosis involves nervous system in around 10-15% of the cases, the commonest presentation being aseptic meningitis. Most of the clinical features of neuroleptospirosis are due to capillary endothelial damage and vasculitis. Ataxia is an extremely uncommon manifestation of Leptospirosis occuring in 1:800) . She was treated with intravenous ceftriaxone for 14 days following which she showed marked recovery. Conclusion The clinical features of neuroleptospirosis are varied, most of them resulting from endothelial damage and vasculitis. Immune mediated phenomenon with no structural damage is another possible mechanism leading to cerebellar ataxia. Cerebellar ataxia due to common tropical infections should be ruled out in the appropriate setting, as early institution of treatment can abate neurological morbidity. The case report highlights the importance of identifying a reversible cause of cerebellar ataixa due to a tropical infection, possibly due to a immune mediated phenomenon, and would be of interest to both internists and neurologists.

Background Unilateral isolated abducens palsy can occur due to any lesion from pons to orbit. The precise localization is made through the associated neurological signs. Parkinson syndrome is a symptom complex of unilateral abducens palsy with ipsilateral postganglionic Horner syndrome localizing the lesion to posterior cavernous sinus. Results We describe here a 55 year old lady who presented with headache and diplopia for 3 months. On examination she had right lateral rectus palsy and postganglionic Horner syndrome. No other neurological deficit was present. MRI brain and MRA of intracranial vessels showed aneurysm of the right cavernous internal carotid artery which was confirmed on cerebral angiography. Endovascular coiling was advised but refused by the patient and she was treated symptomatically Conclusions Parkinson syndrome gives precise localization to unilateral abducens palsy and hence is a valuable clinical pearl.