Hypertrophic Pachymeningitis Possibly Secondary to Otitis Media

Area of Science:

• Neurology
• Otolaryngology
• Immunology

Background:

• Hypertrophic pachymeningitis is a rare condition characterized by inflammation and thickening of the dura mater.
• Cranial nerve involvement can lead to diverse neurological deficits.

Purpose of the Study:

• To describe a case of hypertrophic pachymeningitis associated with otitis media.
• To illustrate the clinical presentation, diagnostic findings, and treatment response.

Main Methods:

• A detailed clinical case presentation of a 46-year-old female patient.
• Neurological examination, cerebrospinal fluid pressure monitoring, and neuroimaging (MRI/CT).
• Treatment with high-dose corticosteroid pulse therapy.

Main Results:

• The patient presented with hearing impairment, headache, and multiple cranial nerve palsies (optic, vestibulocochlear, trigeminal).
• Cerebrospinal fluid pressure increased, and imaging showed progressive involvement of the tentorium cerebelli.
• Significant symptom improvement was observed after corticosteroid treatment.

Conclusions:

• Hypertrophic pachymeningitis can present with varied neurological symptoms, potentially linked to otitis media.
• Corticosteroid therapy may be effective, likely due to modulation of postinfectious immune-inflammatory responses.