Paraneoplastic Neurologic Syndrome in Ewing Sarcoma

      A 30-year-old previously healthy man presented with acute-onset diplopia for 1 month, along with vertigo. A day prior to symptom onset, he also reported mid-back pain radiating to the right abdomen, and erectile dysfunction. Two weeks after symptom onset, he developed hypersensitivity in his feet, an urge to move his legs, and intermittent numbness in the groin with constipation and urinary hesitancy. The patient subsequently saw a neurologist, who diagnosed him with restless leg syndrome that improved with pramipexole. Outside-hospital brain magnetic resonance imaging showed no abnormalities. Additional spinal imaging was planned but, due to delays, he presented to us for evaluation.
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