Idiopathic hypertrophic pachymeningitis responsive to mycophenolate.

Idiopathic hypertrophic pachymeningitis (IHP) represents a rare inflammatory condition that affects the central nervous system, often difficult to treat. We report the case of a patient who presented with difficulty in swallowing, slurred speech and ataxia associated with headache, vomiting and weight loss. He was diagnosed with IHP. He deteriorated despite treatment with high dose steroids and other immunosuppressants, including pulsed cyclophosphamide. Mycophenolate mofetil was therefore administered resulting in improvement and stabilization. This is the first report in English literature of the use of mycophenolate mofetil in the treatment of IHP and could stimulate further research in its efficacy in managing this condition.