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Letters to the Editor
September 2000

Levodopa Toxicity in Parkinson Disease—Reply

Arch Neurol. 2000;57(9):1380-1383. doi:

In reply

We apologize to Dr Lessell for having missed his report of pachymeningitis and temporal arteritis. We agree that the association of temporal arteritis and what has often been referred to as idiopathic cranial pachymeningitis is not coincidental since the dura is supplied by the middle meningeal artery, which is a branch of the external carotid, the vessel often involved in temporal arteritis. We agree that a search for an underlying vasculitis should be made as part of the workup for unexplained dural enhancement or inflammation. If the temporal artery is not involved, then other types of systemic vasculitis should be ruled out since there are now several reports of vasculitis with dural involvement, as we referenced in our article.1

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