Inflammation of the pachymeninges resulting in localised or diffuse thickening of the dura mater which can be caused by chronic infection, inflammatory and immune-mediated disorders and malignancies. The cranial and/or the spinal dura may be affected. Neurological features include headache, visual disturbance, cranial nerve palsies, ataxia and with spinal involvement, limb weakness, sensory impairment and sphincter disturbances . Diagnosis may be aided by neuroimaging and spinal fluid analysis.