Leptomeningeal Myelomatosis Manifesting as Isolated Aphasia

Leptomeningeal myelomatosis represents an uncommon but clinically consequential form of extramedullary disease. Because its manifestations frequently overlap with vascular and infectious conditions, timely recognition is challenging. In particular, isolated speech disturbance without accompanying motor deficits can be misattributed to acute ischemic stroke or focal seizures, potentially delaying appropriate therapy. Here, we report a case of 81-year-old female patients presenting with global aphasia. In this case, brain magnetic resonance imaging and cerebrospinal fluid study including cytology demonstrated leptomeningeal involvement by multiple myeloma.