Meningeal symptoms are the first manifestations in some patients (pain and seizures are the most common presenting complaints) and can include the following:

Headaches (usually associated with nausea, vomiting, light-headedness)

Gait difficulties from weakness or ataxia

Memory problems

Incontinence

Sensory abnormalities

CNS symptoms are divided into the following 3 anatomic groups:

Cerebral involvement: Headache, lethargy, papilledema, behavioral changes, and gait disturbance.

Cranial-nerve involvement: Impaired vision, diplopia, hearing loss, and sensory deficits, including vertigo; cranial-nerve palsies commonly involve CN III, IV, VI, VII, and VIII

Spinal-root involvement: Nuchal rigidity and neck and back pain, or invasion of the spinal roots.