We report a 68-year-old man without clinical history of rheumatoid arthritis who presented with acute bilateral palsy of the IX and X cranial nerves secondary to pachymeningitis confirmed on cranial MRI. Rheumatoid factor in both serum and cerebrospinal fluid and anti-agalactosyl IgG antibody in serum were positive. The radiographs of hands and feet revealed signs of early rheumatism. The dural biopsy specimen showed chronic inflammation with infiltration of lymphocytes and histiocytes. A diagnosis of rheumatoid cranial pachymeningitis was made. Treatment with long-term corticosteroid was excellently effective.
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Third Mil Med Univ, Dept Neurol, Xinqiao Hosp, Chongqing 400037, Peoples R ChinaThird Mil Med Univ, Dept Neurol, Xinqiao Hosp, Chongqing 400037, Peoples R China
Zhou, Zhujuan
Li, Qianning
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Third Mil Med Univ, Dept Neurol, Xinqiao Hosp, Chongqing 400037, Peoples R ChinaThird Mil Med Univ, Dept Neurol, Xinqiao Hosp, Chongqing 400037, Peoples R China
Li, Qianning
Zheng, Jian
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Third Mil Med Univ, Dept Neurol, Xinqiao Hosp, Chongqing 400037, Peoples R ChinaThird Mil Med Univ, Dept Neurol, Xinqiao Hosp, Chongqing 400037, Peoples R China
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Royal North Shore Hosp, Dept Neurol, Sydney, NSW, AustraliaRoyal North Shore Hosp, Dept Neurol, Sydney, NSW, Australia
Tynan, Dominique
Ahmad, Kate
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Royal North Shore Hosp, Dept Neurol, Sydney, NSW, Australia
Royal Australasian Coll Phys, Sydney, NSW, AustraliaRoyal North Shore Hosp, Dept Neurol, Sydney, NSW, Australia
Ahmad, Kate
Thieben, Mark
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Royal North Shore Hosp, Dept Neurol, Sydney, NSW, Australia
Royal Australasian Coll Phys, Sydney, NSW, AustraliaRoyal North Shore Hosp, Dept Neurol, Sydney, NSW, Australia