Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 4 2 2019 08 06 29 34 Hamid Fateh Department of Physical Medicine and Rehabilitation, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Alireza Khoshnevisan Department of Neurosurgery, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mina Meshkini Department of Physical Medicine and Rehabilitation, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Aidin Heidari Department of Physical Medicine & Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. 2018 11 23 2019 03 12 Intramedullary Spinal Cord Metastases (ISCMs) are rare, especially in squamous non-small cell lung cancer simultaneous with Acute Motor and Sensory Axonal Neuropathy (AMSAN); diagnosing these phenomena may be challenging. We report a 56-year-old man presenting with rapidly symmetrical progressive ascending weakness and paresthesia, especially in lower extremities, urinary and fecal incontinence, without any pain or respiratory symptoms. Thoracic spine MRI with and without gadolinium revealed an enhancing intramedullary lesion at the T3-T5 level. Chest CT discovered subpleural pulmonary lesion. The result lung biopsy was consistent with poorly differentiated squamous cell carcinoma, and electrodiagnosis noted severe axonal loss in motor and sensory studies with significant membrane instability and neurogenic findings in electromyography. After 8 months, the patient received just one cycle of chemotherapy and died 6 months later. AMSAN was associated with ISCM of non- small cell lung cancer in this case, who has not been previously reported in the literature. https://crcp.tums.ac.ir/index.php/crcp/article/view/237 https://crcp.tums.ac.ir/index.php/crcp/article/download/237/310