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Rheumatoid meningitis mimicking progressive supranuclear palsy.
MedLine Citation:
PMID:  21532380     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
INTRODUCTION: Rheumatoid meningitis is an uncommon manifestation of longstanding rheumatoid arthritis and few cases have been described. The clinical presentation is extremely variable as reported in medical literature.
CASE REPORT: We report a 71-year-old woman with 15 years of seropositive rheumatoid arthritis who developed neurological complications: cognitive deterioration; hypomimia; limitation on vertical gaze; and axial stiffness, resembling progressive supranuclear palsy and seizures. Brain magnetic resonance imaging showed a diffuse dural plaque on both frontal and temporal lobes exhibiting homogeneous gadolinium enhancement. There was diffuse leptomeningeal enhancement and hyperintense white matter lesions. The final diagnosis made by image-guided biopsy showed rheumatoid pachymeningitis. After the definitive diagnosis, high doses of corticosteroids and immunosuppressive treatment were started.
CONCLUSIONS: We emphasize the diagnostic importance of the biopsy in cases of chronic pachymeningitis and stress that diverse entities can cause progressive supranuclear palsy-like phenotypes.
Authors:
Maria Jose Aguilar-Amat; Maria Jose Abenza-Abildúa; Francisco Vivancos; Francisco Javier Rodríguez de Rivera; Carmen Morales-Bastos; Maria Luisa Gandía-Gonzalez; Alvaro Pérez-Zamarrón; Javier Arpa
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The neurologist     Volume:  17     ISSN:  1074-7931     ISO Abbreviation:  Neurologist     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9503763     Medline TA:  Neurologist     Country:  United States    
Other Details:
Languages:  eng     Pagination:  136-40     Citation Subset:  IM    
Affiliation:
Departments of *Neurology †Neuropathology ‡Neurosurgery, La Paz University Hospital, Madrid, Spain.
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