Table of Contents
Washington University Experience | MISCELLANEOUS | Idiopathic Hypertrophic Pachymeningitis (IgG4 Disease) | 5A0 Case 5 History
Case 5 History ---- This 31 year old woman had been in good health all her life except for migrainous headaches affecting alternating sides since puberty which became persistent and left sided. She experienced an episode of numbness on the right side of the face. An occurrence of mouth and jaw twitching progressed to a generalized tonic-clonic seizure. An EEG showed wave and spike activity in the left temporal area. A CT scan and MRI of the head were read as normal. She was put on Dilantin and remained free of seizures but continued to suffer from severe headaches. A repeat MRI, eight months later, revealed an "en plaque" dural lesion in the left frontoparietal area without evidence of mass effect. On post-gadolinium images the mass demonstrated homogeneous enhancement. A craniotomy was performed and a piece of dura obtained. The diagnosis made was idiopathic hypertrophic pachymeningitis. (AANP Diagnostic Slide Session 1991, Case 8)
