Numbness and ataxia

A 37-year-old man presented with facial numbness, diplopia, gait ataxia, and glossolalia for 29 months. Brain MRI showed gadolinium enhancement peppering the pons and extending into the midbrain, medulla, brachium pontis, cerebellum, and thalamus. The patient's CNS symptoms had improved significantly. These were accompanied by a marked improvement in radiological findings after glucocorticoid therapy. The disease course was relapsing-remitting and glucocorticoid-dependent. Multiple nodules in the abdomen were accidentally discovered by the abdominal computed tomography (CT) during the remission period. A biopsy of the abdominal node and its histological examination was done.