We present a patient with subacute progressive paraparesis secondary to intravascular lymphoma restricted to the spinal cord where initial laboratory and imaging studies were inconclusive. We emphasise the importance of a systematic approach to the diagnosis and highlight the utility of spinal cord biopsy to establish the definitive diagnosis of this rare but treatable illness.

Case presentation: A previously healthy 12 year-old male presented to our tertiary emergency care with classic meningoencephalitis symptoms and paraparesis, urinary retention, facial nerve palsy, lagophtalmos, abducens oculomotor palsy hypoesthesia secondary sinusitis complications. These were intracranial lesions, multiple ischemic subcortical areas myelitis. The diagnosis was made through cli...