Conclusion
We describe a unique case of a 25-year-old male with seizures whose clinical presentation was imitating an array of diseases making it a diagnostic challenge. Histopathology from two sites was performed; this aided in confirming the diagnosis of an IG4 related disease. This case reinforces the fact that it is crucial to consider the diagnosis of IgG4-RD in those presenting with pachymeningitis. A tissue diagnosis is imperative in this circumstance so that the appropriate management can be commenced, and complications avoided.