Abstract
Rheumatoid meningitis (RM), a rare neurological complication of rheumatoid arthritis (RA), presented as hypertrophic pachymeningitis and leptomeningitis in two octogenarian patients. Case 1 had established RA, while Case 2 was diagnosed with RA after neurological onset. Both patients initially received high doses of corticosteroids. Due to age and the need for steroid sparing, tocilizumab was administered. Both showed significant clinical and radiological improvements, allowing for successful corticosteroid tapering. Tocilizumab appears to be effective for RM, especially in elderly patients, as it mitigates the risks associated with long-term corticosteroid use.