Chronic repetitive nonprogressive epilepsia partialis continua due to rheumatoid meningitis.

Department of Neurology
 
Abstract
Our case report describes a patient with recurrent episodes of epilepsia partialis continua (EPC) due to rheumatoid meningitis (RM). RM is an uncommon complication of rheumatoid arthritis (RA) and even rarer cause of seizures. It frequently occurs in patients with little or no systemic symptoms of RA, which may lead to a thorough and time-consuming differential diagnostic workup. To our knowledge, occurrence of EPC was not yet described in this condition. Brain biopsy analysis is mandatory for diagnosis; not only to give evidence of chronic lymphocytic fibroproductive leptomeningitis, but also to rule out leptomeningeal metastases and other causes of chronic meningitis (especially tuberculous meningitis and neurosarcoidosis). Although difficult to diagnose, RM has a favorable prognosis due to its rapid response to glucocorticoid therapy. Therefore, brain biopsy should not be delayed, especially in cases with characteristic magnetic resonance findings.