Abstract
A 66-year-old man with idiopathic cranial pachymeningoencephalitis was described. He suffered from left orbital pain, and character changes. He became short tempered, and was very attached to trifles. Two years prior to these symptoms, he had developed transient left abducent nerve palsy. Head MRI showed a thickening and enhancement of the dura mater on gadolinium-enhanced T1-weighted images, and high signal intensity lesions at bilateral frontal lobes predominantly in the white matter on T2-weighted images. Biopsies revealed microglial proliferation in the cerebral parenchyma, and mild lymphocytic perivascular infiltration. No evidence of intracranial infection was detected. We therefore treated him with methylprednisolone pulse therapy followed by oral prednisolone. His character became gradually normalized, and bilateral frontal lobe lesions seen on MRI disappeared. This is the first case to describe recurrent pachymeningoencephalitis with character changes, and symptoms were probably due to frontal lobe dysfunction.
References
Jan 1, 1992·Clinical Neurology and Neurosurgery·H MuraiK Hasuo
Apr 1, 1992·Journal of Neurology, Neurosurgery, and Psychiatry·D RanouxJ L Mas
Jan 1, 1990·Acta Neuropathologica·T OritaH Ito
Sep 1, 1985·Journal of Neurology, Neurosurgery, and Psychiatry·A P MooreE L Jones
Feb 1, 1994·Neurologia Medico-chirurgica·K YamashitaT Nogawa
Oct 1, 1995·Journal of Neurology, Neurosurgery, and Psychiatry·Y Kawano, J Kira
Jun 1, 1993·Internal Medicine·M FujimotoI Goto
Jul 1, 1993·Neurology·H NishinoJ E Parisi
Jul 1, 1993·Neurosurgery·C KadoyaA Yokota
Sep 1, 1996·Journal of Neurology·T YasutakeT Kobayashi
Nov 1, 1996·Journal of Neurosurgery·Y RiverT Siegal
Feb 5, 1999·Neurology·J Y LiY K Lo
Jun 15, 2000·Neurologia Medico-chirurgica·H NakazakiT Abe
May 1, 2001·Neuroradiology·M CelleriniD Cammelli
Mar 10, 2004·Neurology·M J KupersmithH J Mitnick
Apr 13, 2005·Clinical Neurology and Neurosurgery·Deniz TuncelNermin Mutluer
Nov 1, 2014·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·D HarlandA Diamantopoulos
Citations
Jan 1, 2014·BMC Research Notes·Atsushi KanokeTeiji Tominaga
Aug 23, 2011·Journal of Neurosurgery·Eui Hyun KimJong Hee Chang
Sep 29, 2018·BMJ Case Reports·Gesine BoischHeinrich Weßling