Three cases of acute lymphocytic leukemia with neurologic manifestations are presented in which the clinical signs, together with the findings in the spinal fluid, closely resembled those of acute bacterial meningitis.

Review of the literature reveals an infrequent occurrence of neurologic symptoms in leukemia. When present, they usually represent a terminal phenomenon.

The occurrence of a low content of sugar in the cerebrospinal fluid in association with meningeal infiltration of the brain in patients with leukemia has been reported. The relation of this phenomenon to the glycolytic activity of leukemic cells is discussed.

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