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New-onset seizures: an unusual neurologic manifestation of rheumatoid arthritis

Omair Khan1, Sadia Aslam1, Fatemeh Mohammadrezaei1

  • 1Department of Medicine, Maimonides Medical Center, Brooklyn, NY, USA.

Oxford Medical Case Reports
|February 19, 2024
PubMed

Insights

Rheumatoid meningitis, a rare central nervous system complication of rheumatoid arthritis, can cause neurological symptoms. Early diagnosis and steroid treatment are key for managing this condition and preventing seizures.

Area of Science:

  • Neurology
  • Rheumatology
  • Immunology

Background:

  • Rheumatoid arthritis (RA) is a systemic autoimmune disease primarily affecting joints.
  • Central nervous system (CNS) involvement in RA is uncommon, with rheumatoid meningitis being a rare manifestation.

Observation:

  • A 64-year-old male presented with left lower extremity weakness and seizures.
  • Diagnostic work-up included lumbar puncture, brain MRI, and meningeal biopsy.

Findings:

  • Malignancy was ruled out.
  • Findings were consistent with rheumatoid meningitis, characterized by pachymeningeal and leptomeningeal enhancement.
  • The patient received high-dose steroids and anti-seizure medications.

Implications:

  • This case highlights the importance of considering rheumatoid meningitis in RA patients with neurological symptoms.
  • Prompt diagnosis and treatment with corticosteroids can lead to positive patient outcomes.
  • Further research into CNS manifestations of RA is warranted.

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