Wegener's granulomatosis presenting with multiple cranial nerve palsies and pachymeningitis

Earlier estimates from case series show that up to 6.7% of people with WG have an element of pachymeningitis. 1 A more recent analysis of a larger number of patients demonstrated meningeal inflammation in 0.6% of those diagnosed with WG. 2 In our patient, a diagnosis of a venous sinus thrombosis pro...

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Veröffentlicht in:Practical neurology 2013-06, Vol.13 (3), p.193-195
Hauptverfasser: Iqbal, Ahmed Mohammed, Blackburn, Daniel, Rafiq, Muhammad, Sharrack, Basil
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Sprache:eng
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Zusammenfassung:Earlier estimates from case series show that up to 6.7% of people with WG have an element of pachymeningitis. 1 A more recent analysis of a larger number of patients demonstrated meningeal inflammation in 0.6% of those diagnosed with WG. 2 In our patient, a diagnosis of a venous sinus thrombosis prompted anticoagulation with warfarin, thereby precluding a meningeal biopsy. There are, however, case reports of biopsy-proven cranial pachymeningitis in the setting of WG. 3-5 Key histological features documented in these and other cases are of granulomatous necrotising inflammation, giant cells and vasculitis. 6 The differential diagnosis of a basal meningitic process with multiple cranial nerve palsies is wide but commonly involves infection, malignancy or inflammation.
ISSN:1474-7758
1474-7766
DOI:10.1136/practneurol-2012-000340