Muhammad Nafees, Muhammad Hamid Akram.
Idiopathic hypertrophic pachymeningitis.
Pak Armed Forces Med J Jan ;59(4):309-10.

INTRODUCTION Idiopathic hypertrophic pachymeningitis (IHP) is a clinical disorder characterized by localized or diffuse thickening and fibrosis of dura matter with no underlying cause demonstrable [1]. IHP is a rare disorder affecting men more than women [2] with peak incidence in 6th decade of life [3]. Common clinical features include headache, multiple cranial nerve palsies and cerebellar dysfunctions occurring alone or in combination. We present a case of a lady, who was diagnosed in our department after suffering from the disease for some time with no diagnosis available. CASE HISTORY Middle aged lady presented with one month history of drooping of left eyelid along with double vision and pain. She also suffered similar complaints two years back which recovered with treatment from local doctor and homeopath. She also had her computerized tomogram (CT) scan done in last episode with no report available. She is also hypertensive for the same period and complains of palpitation occurring off and on. She had been taking irregular treatment for above complaints. There was no history of surgery, blood transfusion, bronchial asthma, tuberculosis (TB) or Jaundice. She is non-smoker and non –addict .Married for the last 35 years with 3 daughters and one son. Temperature 98oF BP 120/70 mm of Hg. Cranial nerves III, IV and VI and VII on left affected Rest of the systemic examination was normal. CSF routine examination was within normal limits.

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