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[Multiple cranial nerve involvement associated with tentorial pachymeningitis of granulomatous type].

Abstract
Otitis media in a 43 year-old male patient was followed by signs of chronic meningitis with persistent headaches, moderate pleiomorphic lymphocytosis of CSF without hypoglycorrhachia and unilateral impairment of cranial nerves XI to II. These signs were accompanied by widespread inflammation with general deterioration of the patient's condition. After a time the tentorium of cerebellum showed thickening and significant contrast uptake in conjunction with necrotizing granulomatous inflammation, indicating tentorial pachymeningitis. Swift and complete remission was obtained with a corticoid-cyclophosphamide combination. After reviewing the other possible causes of chronic meningitis, the authors proposed a diagnosis of Wegener's disease of auricular origin in view of the compatibility of all the data. A few cases of cranial pachymeningitis of indeterminate origin are described in the literature. Only this patient was treated with a corticoid-cyclophosphamide combination. The remarkable efficacy of this double therapy confirms the diagnostic hypothesis of Wegener's granulomatosis.
AuthorsS Ghilain, V Delreux, L Kevers, C J Sindic, P Mathurin, E C Laterre
JournalActa neurologica Belgica (Acta Neurol Belg) 1988 Mar-Apr Vol. 88 Issue 2 Pg. 91-100 ISSN: 0300-9009 [Print] Italy
Vernacular TitleAtteinte multiple des paires crâniennes associée à une pachyméningite tentorielle à caractère granulomateux.
PMID3389076 (Publication Type: Case Reports, English Abstract, Journal Article)
Chemical References
  • Adrenal Cortex Hormones
  • Cyclophosphamide
Topics
  • Accessory Nerve
  • Adrenal Cortex Hormones (administration & dosage)
  • Adult
  • Cranial Nerve Diseases (complications)
  • Cyclophosphamide (administration & dosage)
  • Drug Therapy, Combination
  • Dura Mater
  • Granulomatosis with Polyangiitis (drug therapy, etiology)
  • Humans
  • Male
  • Meningitis (drug therapy, etiology)
  • Optic Nerve
  • Otitis Media (complications)

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