Chronic Maningitus

The longer i'm practising, the more i see rheumatoid ar thritus popping up as a bad actor in the central nervous system. I wasn't taught much about but it also seems to me like it's difficult to prove. With focal packy menagil and lepta menigial involvement, particularly over the convexity, i think it's something at least that should be considered in patients who have relative good control of their systemic disease. And indeed, there can be a fairly striking pleocytosis present in the spinal fluid as well. So its not exclusively confined to the dura.