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Hypertrophic chronic pachymeningitis associated with Epstein-Barr virus reactivation: a case report

Raffaele Nardone1,2, Francesco Brigo3, Markus Covi3

  • 1Department of Neurology, Franz Tappeiner Hospital, Via Rossini 5, I-39012, Merano (BZ), Italy. raffaele.nardone@asbmeran-o.it.

Journal of Neurovirology
|February 13, 2019
PubMed

Insights

A rare inflammatory condition, hypertrophic pachymeningitis, thickened the dura mater in a patient with headache and cranial nerve palsy. Epstein-Barr virus (EBV) was detected, and symptoms improved with treatment, expanding the known neurological effects of EBV.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Neuroinflammation

Background:

  • Hypertrophic pachymeningitis is a rare dural thickening condition.
  • Intractable headache and cranial nerve palsy are significant neurological symptoms.

Observation:

  • A patient presented with severe headache and cranial nerve deficits.
  • Neuroimaging revealed frontal dural hypertrophy.
  • Cerebrospinal fluid showed pleocytosis and positive Epstein-Barr virus (EBV) PCR.

Findings:

  • Epstein-Barr virus (EBV) was identified as a potential cause of hypertrophic pachymeningitis.
  • Acyclovir and corticosteroid treatment led to clinical symptom improvement.
  • Dural pathology on imaging did not significantly change despite clinical recovery.

Implications:

  • This case expands the spectrum of neurological manifestations associated with Epstein-Barr virus (EBV).
  • Highlights the importance of considering viral etiologies in inflammatory pachymeningitis.
  • Suggests a potential role for antiviral therapy in specific EBV-related neurological cases.
Keywords:
AcyclovirCorticosteroid treatmentEpstein-Barr virusHypertrophic pachymeningitisNeuroinflammation

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