A case of neuroleukemiosis: The usefulness of nerve ultrasound as a diagnostic tool

Abstract

A case of neuroleukemiosis: The usefulness of nerve ultrasound as a diagnostic toolNeuroleukemiosis is a condition in which leukemic blasts infiltrate peripheral nerves with or without central nervous system involvement. 1 Herein, the authors report a patient with acute myeloid leukemia (AML) for whom peripheral nerve ultrasound was helpful for the diagnosis of neuroleukemiosis in the tibial nerve.A 52-y-old female with AML became aware of paresthesias of the left lower limb. She had been diagnosed with M5b type AML 1 y prior to the onset of the symptom, and undergone remission induction and consolidation therapy, including daunorubicin, cytarabine, and mitoxantrone.After achieving remission, she had also undergone allogenic hematopoietic stem cell transplantation 6 mo prior to the neurological symptom onset. The patient was seen for neurological evaluation 4 mo after onset of paresthesias. On a neurological examination, her cognitive function was normal and there was no involvement of cranial nerves. There was no upper limb weakness. She demonstrated grade 3/5 Medical Research Council (MRC) strength of left plantar flexion and toe flexion. Strength of other muscles in the left lower extremity and of all muscles in the right lower extremity was normal. The patient had hypoalgesia of the right toe