After having had every test in the book, I was diagnosed with PACNS almost 3 years ago,
and the course has been unremitting. The original presentation was headache (not thunderclap)
loss of executive function and memory, visual disturbances, 7 strokes 9ischemic) and a drop of at least 40 !Q points on neuropsyche testing. I have tried both MTX and AZA, but both make me violently ill. I'm back to the CTX -150 mg/day,now, and it seems to be finally keeping the brain fog away.