A 69-year-old woman with double vision and lower-extremity weakness

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Figure 1
Magnetic resonance imaging of the lumbar spine with contrast showed cauda equina enhancement at level L5 to S1 (arrows) in axial T1 sequence (top) and sagittal T1 sequence (bottom).

TABLE 1

Results of cerebrospinal fluid analysis

	Value	Reference range
Red blood cells	14/μL	0–1
White blood cells	264/μL	0–5
Protein	140 mg/dL	15–45
Glucose	44 mg/dL	40–70
Immunoglobulin G index	0.65	0–0.61
Oligoclonal bands	None seen
Gram stain and culture	No growth and no organisms seen
Fungal stain and culture	Negative cryptococcal antigen, no fungus isolated > 20 days
Viral studies	Polymerase chain reaction testing negative for herpes simplex, cytomegalovirus, Epstein-Barr, varicella zoster, and West Nile viruses