Granulomatous Meningoencephalitis

(GME)

• An idiopathic CNS conditon
• May occur as:
  • A disseminated disease
  • A focal mass lesion
  • A primary occular disease
• Brainstem signs are common, although the forebrain is primarily affected.
• May be incorrectly diagnosed as lymphoma.
• Changes are apparent in the CSF.
  • There is usually a mononucloear pleocytosis.
  • Sometimes only protein is elveated.
• Diffuse inflammatory changes or a mass lesion will be seen by advanced imaging.
  • However, biopsy is required for a definative diagnosis.
• Life span is between 6 months and 1 year from diagnosis.

Treatment

• Immunosuppression:
  • Corticosteroids
  • Azathioprine
  • Cycophosphamide
• Surgery
  • This is only appropriate if there is a focal mass.
• Radiation therapy.