Case 36-1991

Presentation of Case A 60-year-old man was admitted to the hospital because of progressive neurologic dysfunction and persistent elevation of the lactic dehydrogenase (LDH) level. The patient was well until 18 days earlier, when he experienced bilateral facial and head pain that was treated with pseudoephedrine and a few tablets of penicillin. The pain persisted, and about two weeks before admission he had diplopia for five minutes. Eight days before entry the patient awoke in the morning with an excruciating right periorbital and frontal headache and was taken to another hospital. General physical examination was reported to be negative, with . . .