Rheumatoid Meningitis

Angela M. Parsons, Leslie A. Zuniga, Joseph M. Hoxworth, Mark Lyons, Fawad Aslam, Brent P. Goodman

Research output: Contribution to journalReview articlepeer-review

7 Scopus citations


Introduction: Rheumatoid meningitis (RM) is a rare complication of rheumatoid arthritis (RA) and has a high mortality rate. It can present as a first diagnosis of RA, in long-standing disease, or in active or well-controlled disease. Neurological manifestations vary widely. Case Report: A patient with a 30-year history of RA, well controlled with methotrexate therapy, presented with new-onset seizures. Magnetic resonance imaging showed leptomeningeal and pachymeningeal enhancement. A de novo workup resulted in diagnosis of RM. Conclusions: Cerebrospinal fluid findings for RM are nonspecific, typically lymphocytic pleocytosis; however, they can be neutrophilic, as in this case. Magnetic resonance imaging findings consist of leptomeningeal and pachymeningeal enhancement but can also involve the parenchyma. The diagnosis is typically confirmed with meningeal biopsy. Treatment involves high-dose corticosteroids or immunomodulatory therapy, or both. Long-term follow-up with radiologic surveillance typically ranges from improvement to resolution.

Original languageEnglish (US)
Pages (from-to)83-85
Number of pages3
Issue number3
StatePublished - Jan 1 2018
Externally publishedYes


  • rheumatoid arthritis
  • rheumatoid meningitis
  • rheumatoid pachymeningitis

ASJC Scopus subject areas

  • Clinical Neurology


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