Volume 26, Issue 127, September 2022

IgG4 related cranial pachymeningitis and extraocular muscle paralysis

Balambighai V^1♦, Dhanaraj M²

¹Assistant Professor, Department of Neurology, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India
²Senior Consultant, Department of Neurology, Apollo Main Hospital, Chennai, Tamil Nadu, India

^♦Corresponding author
Assistant Professor, Department of Neurology, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India

ABSTRACT

In this case report we discuss a case of IgG4 related cranial pachymeningitis with isolated extraocular muscle paralysis in a middle aged woman. MRI Brain showed thickened and enhancing pachymeninges and superior recti muscles, with raised serum IgG4 levels. A diagnosis of “possible” IgG4 Related pachymeningitis was considered, and was treated with steroids. She responded well over a period of two months. At the end of two months, the clinical response was good and serum IgG4 levels became normal. IgG4 RD may be considered as a possible differential in all cases of idiopathic pachymeningitis in view of excellent therapeutic response to steroids.

Keywords: IgG4 related cranial pachymeningitis, extraocular muscle paralysis, corticosteroids

Medical Science, 2022, 26, ms357e2349

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DOI: https://doi.org/10.54905/disssi/v26i127/ms357e2349

Published: 08 September 2022