A 41-YEAR-OLD MALE WITH PROGRESSIVE PARAPARESIS 2014 American Academy of Neurology Vignette 41-year-old male Bilateral legs numbness and paraparesis for 3 months No trauma history Neurological examination: sensory and motor impairment below T4 dermatome and hyperreflexia Hsu et al. 2014 American Academy of Neurology Imaging Hsu et al. 2014 American Academy of Neurology Idiopathic hypertrophic spinal pachymeningitis mimicking epidural lymphoma Hsu et al. 2014 American Academy of Neurology IHSP is a rare inflammatory disease characterized by hypertrophic inflammation of the dura mater Typical MRI finding of IHSP: long epidural mass of low T2 signal intensity with peripheral enhancement Homogeneous enhancement is typical of and could be mistaken for epidural lymphoma