A Rare case of pachymeningitis in neurosarcoidosis

Sixth nerve palsy due to pachymeningitis is a rare manifestation of neurosarcoidosis. it can resemble other disorders associated with tentorial thickening . diagnosis of sarcoidosis is difficult when neurological involvement is the first or only manifestation of the disease. No reliable diagnostic test for neurosarcoidosis exists. However CT and MR can help differentiate it from these other disorders. Here we present a rare case of neurosarcoidosis presenting as pachymeningitis with sixth nerve palsy picked up by MRI. There was significant improvement after administration of immunosuppressant.