以枕神经痛为表现的特发性肥厚性硬脑膜炎
Idiopathic hypertrophic pachymeningitis presenting with occipital neuralgia.
作者信息
Auboire Laurent, Boutemy Jonathan, Constans Jean Marc, Le Gallou Thomas, Busson Philippe, Bienvenu Boris
机构信息
Université François-Rabelais de Tours, Inserm, Imagerie et Cerveau UMR U930, Tours, France.
CHU de Caen, Department of internal medicine, 14000-Caen, France.
出版信息
Afr Health Sci. 2015 Mar;15(1):302-6. doi: 10.4314/ahs.v15i1.42.
BACKGROUND
Although occipital neuralgia is usually caused by degenerative arthropathy, nearly 20 other aetiologies may lead to this condition.
METHODS
We present the first case report of hypertrophic pachymeningitis revealed by isolated occipital neuralgia.
RESULTS AND CONCLUSIONS
Idiopathic hypertrophic pachymeningitis is a plausible cause of occipital neuralgia and may present without cranial-nerve palsy. There is no consensus on the treatment for idiopathic hypertrophic pachymeningitis, but the usual approach is to start corticotherapy and then to add immunosuppressants. When occipital neuralgia is not clinically isolated or when a first-line treatment fails, another disease diagnosis should be considered. However, the cost effectiveness of extended investigations needs to be considered.
背景
尽管枕神经痛通常由退行性关节病引起，但近20种其他病因也可能导致这种情况。
方法
我们报告首例以孤立性枕神经痛为表现的肥厚性硬脑膜炎病例。
结果与结论
特发性肥厚性硬脑膜炎可能是枕神经痛的一个合理病因，且可能不伴有脑神经麻痹。对于特发性肥厚性硬脑膜炎的治疗尚无共识，但通常的方法是先开始皮质激素治疗，然后加用免疫抑制剂。当枕神经痛并非临床孤立存在或一线治疗失败时，应考虑其他疾病诊断。然而，需要考虑进一步检查的成本效益。
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