This 36-year-old man presented with a 2-month history of generalized epileptic activity and altered perception. Upon examination by a neurologist he was begun on antiepileptic treatment, which consisted of carbamazepine 400 mg daily. His medical history was unyielding. Neurological examination was remarkable for bilateral Babinski's sign. Cranial magnetic resonance imaging (MRI) revealed multiple dural-based enhancing lesions with cerebral edema (Figure 1). Chest X-rays appeared normal, and the CSF was clear. The patient underwent a right frontal stereotaxic awake craniotomy for histopathological diagnosis. At craniotomy the outer layer of the dura was firm and thickened and avascular pinkish, firmly involved the inner layer, fibrous masses resembling meningioma. Histological examination revealed multiple confluent necrotizing and nonnecrotizing granulomas with giant cells (multinucleated and Langhans' type) (Figure 2). Microbiological studies did not reveal acid-fast bacilli. The patient was placed on a regimen of anti-TB medication for 18 months, which consisted of rifampicin (600 mg/daily), ethambutol (1500 mg/daily), and isoniazid (300 mg/daily). The patient's seizures were controlled with phenytoin 300 mg/day, and follow-up MRI at the end of the second postoperative year showed regression of the lesions (Figure 3).