Hypertrophic chronic pachymeningitis associated with Epstein-Barr virus reactivation: a case report
Hypertrophic pachymeningitis is a rare inflammatory condition characterized by the thickening of the dura mater. We describe a patient who presented with intractable headache and complex cranial nerve palsy. Hypertrophy of the frontal dura was accompanied by pleocytosis and detection of Epstein-Barr virus (EBV) by PCR in cerebrospinal fluid. Clinical symptoms gradually improved after acyclovir and corticosteroid treatment, whereas dural pathology remained unchanged on neuroimaging. This case points at an expansion of the spectrum of neurological manifestations for EBV.
KeywordsHypertrophic pachymeningitis Epstein-Barr virus Neuroinflammation Acyclovir Corticosteroid treatment
- Ascenção BB, Gonçalves AC, Luís N, Sá J, Brito AP, Poças JM (2016) Epstein-Barr virus hemorrhagic meningoencephalitis: case report and review of the literature. J Neuro-Oncol 22(5):695–698Google Scholar
- Cocuzza CE, Piazza F, Musumeci R, Oggioni D, Andreoni S, Gardinetti M, Fusco L, Frigo M, Banfi P, Rottoli MR, Confalonieri P, Rezzonico M, Ferrò MT, Cavaletti G, EBV-MS Italian Study Group (2014, 2014) Quantitative detection of Epstein-Barr virus DNA in cerebrospinal fluid and blood samples of patients with relapsing-remitting multiple sclerosis. PLoS One, 4 9:e94497Google Scholar
- Dunmire SK, Hogquist KA, Balfour HH (2015) Infectious mononucleosis. Curr Top Microbiol Immunol 390(Pt 1):211–240Google Scholar
- Ranasinghe MG, Zalatimo O, Rizk E, Specht CS, Reiter GT, Harbaugh RE, Sheehan J (2015) Idiopathic hypertrophic spinal pachymeningitis. J Neurosurg Spine 15(2):195–201Google Scholar