Disk edema and peripheral neuropathy

A 55-year-old woman presented with an eight-year history of progressive gait dysfunction and a 2-3 week history of horizontal diplopia. Examination of the patient revealed acute papilledema, intermittent esotropia, and upper and lower motor neuron findings in her lower extremities. CT scan of the head showed communicating hydrocephalus. A spinal cord tumor extending from T11 to L3 was visualized by MR imaging of the spine. All of her symptoms, except for a left foot drop, resolved with aggressive removal of the tumor, which was a myxopapillary ependymoma. Mechanisms of the neuro-ophthalmic picture and treatment of this syndrome are discussed.