Abstract
Granulomatosis with polyangiitis (GPA) is a rare systemic vasculitis that can involve multiple organ systems, including the nervous system. Central nervous system (CNS) involvement, especially in the form of cranial nerve neuropathy, is uncommon and may present with significant diagnostic challenges. This case report details the presentation, diagnostic workup, and management of a 60-year-old female who initially developed unilateral cranial nerve deficits, which progressed to bilateral involvement over an 11-day hospital course. The purpose of this case report is to highlight the importance of including GPA in the differential diagnosis in the setting of progressive cranial neuropathy, and to emphasize the need for a multidisciplinary approach for timely diagnosis and utilization of immunosuppressive treatment to minimize the chronic effects of the disease.