肉芽肿性脑膜反应的特征是肉芽和纤维组织增生、淋巴细胞和巨细胞浸润及反应性动脉内膜炎,可见于梅毒、结核、某些CNS 霉菌感染和神经类肉瘤病时。据作者所知文献报道中仅有两例不是由于上述原因引起。作者报导了第三例不明原因的肉芽肿性脑膜炎,认为这是一种与其它类型肉芽肿性脑膜炎临床不同的疾病单元,而称之为特发性肉芽肿性脑膜炎。患者系女性,69岁,右利。在住院前8周一直健康。开始行走时右腿沉重乏力,上楼困难。有8次间断的急性下肢轻瘫发作,每次持续10～30分钟。首次发作时语言含糊。近两年体重减轻。有复发性中等度枕部头痛,对镇痛剂有效。查体:血压150/80mmHg,心脏无杂音,胸腹部正常。神经系:步态 Granulomatous meningeal reactions are characterized by proliferation of granulation and fibrous tissue, infiltration of lymphocytes and giant cells, and reactive endocarditis, which can be seen in syphilis, tuberculosis, certain CNS mold infections, and neurogenic sarcoidosis. According to the author’s knowledge, only two cases reported in the literature are not caused by the above reasons. The authors report a third case of granulomatous meningitis of unknown cause, which is considered to be a distinct disease unit from other types of granulomatous meningitis and is called idiopathic granulomatous meningitis. Patient is female, 69 years old, right wing. 8 weeks before hospitalization has been healthy. Right leg when starting to walk heavy fatigue, difficult to go upstairs. There are eight intermittent acute paralysis episodes, each lasting 10 to 30 minutes. The language was vague at the first attack. Weight loss in the past two years. A recurrent moderate occipital headache, analgesics effective. Physical examination: blood pressure 150 / 80mmHg, heart no noise, chest and abdomen normal. Nervous system: gait