title: Idiopathic hypertrophic pachymeningitis presenting with occipital neuralgia.
abstract: 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.
  
  
  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.
authors.affiliation: Université François-Rabelais de Tours, Inserm, Imagerie et Cerveau UMR U930, Tours, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Auboire
authors.affiliation: CHU de Caen, Department of internal medicine, 14000-Caen, France.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Boutemy
authors.affiliation: Université de Caen Basse-Normandie, Medical School, 14000-Caen, France ; CHU de Caen, Department of Radiology, 14000-Caen, France.
authors.forename: Jean Marc
authors.initials: JM
authors.lastname: Constans
authors.affiliation: CHU de Caen, Department of internal medicine, 14000-Caen, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Le Gallou
authors.affiliation: CH d'Avranches, Department of Medicine 2, 50300-Avranches, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Busson
authors.affiliation: CHU de Caen, Department of internal medicine, 14000-Caen, France ; Université de Caen Basse-Normandie, Medical School, 14000-Caen, France.
authors.forename: Boris
authors.initials: B
authors.lastname: Bienvenu
mesh_terms: D003389:Cranial Nerve Diseases / Q000209:etiology / Q000473:pathology*; D003520:Cyclophosphamide / Q000627:therapeutic use; D004388:Dura Mater / Q000000981:diagnostic imaging / Q000473:pathology*; D006261:Headache / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D008581:Meningitis / Q000150:complications / Q000473:pathology*; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology*; D009437:Neuralgia / Q000188:drug therapy / Q000209:etiology*; D011241:Prednisone / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D011241:Prednisone; D008727:Methotrexate
keywords: meningitis; neck pain/aetiology; neuralgia/pathology; review
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