A 65-year-old woman with moderate persistent asthma, hypertension, history of breast cancer (status post bilateral mastectomy and chemotherapy), gastric sleeve surgery, and prior tobacco use presented with a 3-month history of progressive ascending sensory and motor deficits. Prior studies, including electromyography, lumbar puncture, and magnetic resonance imaging, were only notable for C8-T1 radiculopathy with bilateral carpal tunnel syndrome. She had received oral prednisone, with minimal improvement in her neurologic symptoms.