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Chronic meningitis with multiple cranial neuropathies: A rare initial presentation of Wegener's granulomatosis

Vikas Gupta1, Anjani Kumar Sharma, Rajendra Kumar Sureka

  • 1Department of Neurology, Sawai Man Singh Medical College, Jaipur, Rajasthan, India.

Annals of Indian Academy of Neurology
|October 9, 2013
PubMed

Insights

Wegener's granulomatosis, a rare vasculitis, can initially present as chronic meningitis with cranial nerve issues, even without typical respiratory or kidney symptoms. This case underscores the importance of considering this condition in unusual neurological presentations.

Area of Science:

  • Neurology
  • Rheumatology
  • Pathology

Background:

  • Wegener's granulomatosis (WG) is a systemic necrotizing vasculitis primarily affecting small blood vessels.
  • WG commonly involves the respiratory tract and kidneys.
  • Central nervous system (CNS) involvement in WG is infrequent, occurring in approximately 8% of cases.

Observation:

  • A 34-year-old male presented with chronic hypertrophic meningitis and multiple cranial nerve palsies.
  • This neurological presentation was the initial manifestation of the disease.
  • The patient had no concurrent respiratory or renal symptoms suggestive of WG.

Findings:

  • The case demonstrates an unusual initial presentation of Wegener's granulomatosis.
  • Chronic hypertrophic meningitis and cranial nerve involvement are rare initial signs of WG.
  • Diagnostic challenges arise from rare presentations of systemic diseases.

Implications:

  • Wegener's granulomatosis should be included in the differential diagnosis for chronic meningitis.
  • Early recognition of atypical WG presentations is crucial for timely treatment.
  • This case highlights the diverse neurological manifestations possible in WG.
Keywords:
Chronic meningitisWegener's granulomatosiscranial neuropathies

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