title: A presentation of cerebritis secondary to granulomatosis with polyangiitis (wegener).
abstract: Neurological manifestations of GPA are common, most frequently as a peripheral neuropathy. Cerebritis as a principal presentation is extremely rare. We report a patient who presented with subacute progression of ataxia, confusion, and vacant episodes. An MRI of her brain showed bilateral signal abnormalities in the cingulate and superior sagittal gyrus while a staging CT revealed a mass in the right upper lobe of the patient's lung with a satellite nodule. C-ANCA antibodies specific for PR3 at high titres were positive and a diagnosis of GPA was made. The patient was commenced on intravenous methylprednisolone followed by cyclophosphamide and responded well to treatment. GPA is a rare and treatable differential diagnosis for confused patients with acute or subacute neurological features and unusual MRI findings.
authors.affiliation: Department of Neurology, Nottingham University Hospitals NHS Trust, Queen's Medical Centre Campus, Nottingham NG7 2UH, UK.
authors.forename: James
authors.initials: J
authors.lastname: Norman
authors.affiliation: Department of Rheumatology, Nottingham University Hospitals NHS Trust, Queen's Medical Centre Campus, Nottingham NG7 2UH, UK.
authors.forename: Ira
authors.initials: I
authors.lastname: Pande
authors.affiliation: Department of Radiology, Nottingham University Hospitals NHS Trust, Queen's Medical Centre Campus, Nottingham NG7 2UH, UK.
authors.forename: Timothy
authors.initials: T
authors.lastname: Taylor
authors.affiliation: Department of Neurology, Nottingham University Hospitals NHS Trust, Queen's Medical Centre Campus, Nottingham NG7 2UH, UK ; Clinical Neurology Research Group, Division of Clinical Neuroscience, University of Nottingham School of Medicine, C Floor South Block, Queen's Medical Centre, Nottingham NG7 2UH, UK.
authors.forename: Bruno
authors.initials: B
authors.lastname: Gran