An 81-year-old woman presented with progressed gait instability for several months. She had a temperature of about 37.5 °C. The initial neurological examination revealed unsteadiness on the finger-nose and heel-knee-shin tests, along with a wide-based ataxic gait. Gadolinium-enhanced magnetic resonance imaging (MRI) of brain showed ring-like enhancement of multiple nodular lesions in the cerebellum, brain stem and cerebral hemispheres with surrounding edema (Fig. 1). She was underwent lumber puncture and cerebrospinal fluid (CSF) indicated elevated protein (641 mg/dL) and without leucocytes, and laboratorytests for herpes virus, cytomegalovirus, bacteria, acid-fast bacilli, cryptococcosis, human immunodeficiency virus were negative.
