Dr.BURSHINA AT

Dr.VIRNA SHAH

Abstract

A case of Acute lymphoblastic leukemia(ALL) with unusual presentation involving multiple cranial nerves and extraocular muscle is reported.Patient presented to us with acute onset diplopia.Initial consideration in the differential diagnosis were Tuberculosis with central nervous system(CNS) involvement and immune complex deposition disease.Combined use of neuroimaging,CSF cytology and bone marrow biopsy confirmed the final diagnosis as Burkitt’s-type Acute lymphoblastic leukemia with Central nervous system invasion. This case is of particular interest, as careful study of literature reveals ALL presenting with cranial nerve palsies is uncommon.CNS involvement in ALL remains under-diagnosed;therefore,an accurate and timely diagnosis presents a challenge.