Idiopathic hypertrophic pachymeningitis presenting with occipital neuralgia |
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| Authors: | Laurent Auboire Jonathan Boutemy Jean Marc Constans Thomas Le Gallou Philippe Busson Boris Bienvenu |
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| Institution: | 1 Université François-Rabelais de Tours, Inserm, Imagerie et Cerveau UMR U930, Tours, France;2 CHU de Caen, Department of internal medicine, 14000-Caen, France;3 Université de Caen Basse-Normandie, Medical School, 14000-Caen, France;4 CHU de Caen, Department of Radiology, 14000-Caen, France;5 CH d''Avranches, Department of Medicine 2, 50300-Avranches, France |
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| Abstract: | BackgroundAlthough occipital neuralgia is usually caused by degenerative arthropathy, nearly 20 other aetiologies may lead to this condition.MethodsWe present the first case report of hypertrophic pachymeningitis revealed by isolated occipital neuralgia.Results and conclusionsIdiopathic hypertrophic pachymeningitis is a plausible cause of occipital neuralgia and may present without cranial-nerve palsy. There is no consensus on the treatment for idiopathic hypertrophic pachymeningitis, but the usual approach is to start corticotherapy and then to add immunosuppressants. When occipital neuralgia is not clinically isolated or when a first-line treatment fails, another disease diagnosis should be considered. However, the cost effectiveness of extended investigations needs to be considered. |
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| Keywords: | neuralgia/pathology meningitis neck pain/aetiology review |
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