Sequential MRI in chronic meningitis during adrenocorticotropic hormone treatment for West syndrome

I report a patient with West syndrome who suffered from chronic meningitis during adrenocorticotropic hormone treatment. The pleocytosis of cerebrospinal fluid continued, with vacillation, for more than 3 months. Sequential MRI studies with gadolinium contrast seem to be essential for evaluation of the activity and determination of the treatment in chronic meningitis.