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Arch Neurol. 2000;57:1774-1775.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

A 53-YEAR-OLD man was admitted with a 2-day history of odd behavior and increased drowsiness. On the day of admission he suddenly lost the ability to speak. He also had a 3-month history of lethargy, abdominal pain, and weight loss, which had been investigated by his general practitioner. The only abnormality found was a plasma viscosity of 2.27 mPas (normal, 1.25-1.72 mPas). He smoked 20 cigarettes per day. The remainder of the history was unremarkable. On admission he was pyrexial (temperature, 38.0°C) and tachycardic with a global aphasia without hemiparesis. There were no other abnormalities: in particular the findings of cardiovascular examination were normal.

He had a plasma viscosity of 2.5 mPas, a C-reactive protein level of 65 mg/L, and a positive rheumatoid factor with a titer of 1:320. The findings of other investigations, including transthoracic echocardiogram, were all normal. Cranial magnetic resonance imaging (Figure 1) revealed 2 . . . [Full Text of this Article]

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