Neurocutaneous melanosis: an atypical presentation.

An eleven-year-old male child presented with multiple small melanocytic nevi in a generalized distribution and a giant congenital melanocytic nevus (GCMN) over the lumbosacral area since birth. He had had difficulty in walking since the age of two and a half years. Histopathological examination revealed intradermal melanocytic nevi. Serial Magnetic Resonance Imaging (MRI) scans showed brainstem atrophy with central nervous system abnormality suggestive of neuromelanosis. Clinically and histologically, the diagnosis was suggestive of neurocutaneous melanosis (NCM). The present case is reported due to its clinical presentation of quadriparesis, which has been rarely reported as a manifestation of neurocutaneous melanosis.