RESUMO
INTRODUCTION: Myasthenia gravis (MG) and Alzheimer's disease (AD) are two of the most important diseases where the dysregulation of acetylcholine activity plays a crucial role. In the first, this dysregulation happens at the level of the neu-romuscular junction and in the second, in the central nervous system (CNS). AIM: To analyze the possible relationship between these two pathologies, analyzing the prevalence and the odds ratio of AD within patients previously diagnosed with MG. We will compare these data with respect to the prevalence of AD in the general population. PATIENTS AND METHODS: We examined the data obtained by the electronic medical records of patients in the health care system of Castilla La Mancha using the Natural Language Process provided by a clinical platform of artificial intelligence known as the Savana Manager?. RESULTS: We identified 970,503 patients over the age of 60 years, of which 1,028 were diagnosed with MG. The proportion of the patients diagnosed with AD within this group (4.28%) was greater than the rest of the population (2.82%) (p = 0,0047) with an odds ratio of 1.54 (confidence interval at 95% 1.13-2.08; p = 0.0051) without finding significant differences in the bivariate analysis for the rest of the most important actual known risk factors for AD. CONCLUSION: Our results suggest that there might be an increase in the prevalence of AD in patients previously diagnosed with MG.
TITLE: Miastenia gravis y enfermedad de Alzheimer: una asociación a estudio.Introducción. La miastenia gravis (MG) y la enfermedad de Alzheimer (EA) son dos de las enfermedades neurológicas en cuya fisiopatología interviene la acetilcolina en distintos niveles. En la primera, la alteración de este neurotransmisor se produce en la unión neuromuscular, y en la segunda, en el sistema nervioso central. Objetivo. Analizar la posible relación entre dichas patologías estudiando la prevalencia y la odds ratio de la EA dentro de los pacientes diagnosticados de MG con respecto a la prevalencia de EA en la población general. Pacientes y métodos. Se han examinado datos de las historias clínicas electrónicas del sistema de salud de Castilla-La Mancha utilizando el procesamiento de lenguaje natural a través de la plataforma clínica de inteligencia artificial Savana Manager?. Resultados. Se ha identificado a 970.503 pacientes mayores de 60 años, de los que 1.028 tenían diagnóstico de MG. La proporción de pacientes con diagnóstico de EA dentro de este grupo (4,28%) es mayor que en el resto de la población (2,82%; p = 0,0047), con una odds ratio de 1,54 (intervalo de confianza al 95%: 1,13-2,08; p = 0,0051), sin que se encuentren diferencias significativas en el análisis bivariante del resto de los factores de riesgo para EA más importantes conocidos hasta ahora. Conclusiones. Nuestros resultados sugieren que podría existir un aumento de la prevalencia de EA en pacientes con MG.
Assuntos
Doença de Alzheimer , Miastenia Gravis , Humanos , Pessoa de Meia-Idade , Doença de Alzheimer/epidemiologia , Doença de Alzheimer/complicações , Inteligência Artificial , Miastenia Gravis/complicações , Miastenia Gravis/epidemiologia , Fatores de Risco , AcetilcolinaRESUMO
BACKGROUND AND PURPOSE: We report a novel mutation in exon 8 of the presenilin 1 (PSEN1) gene (V261L) associated with early-onset autosomal dominant Alzheimer's disease and spastic paraparesis. METHODS AND RESULTS: The proband was a woman who developed insidious cognitive decline with predominant memory loss and gait disorder secondary to spasticity at the age of 40. Her brother and her mother had a similar disease in the fifth decade of life. The feature of amnestic presentation with spastic paraparesis is consistent with the majority of mutations in the exon 8 of the PSEN1 1 gene. CONCLUSIONS: Screening for PSEN1 mutations is especially likely to be productive when directed toward persons with positive family history and with age at onset of under 60.
Assuntos
Doença de Alzheimer/genética , Substituição de Aminoácidos , Mutação de Sentido Incorreto , Paraparesia Espástica/genética , Mutação Puntual , Presenilina-1/genética , Adulto , Idade de Início , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/epidemiologia , Doença de Alzheimer/patologia , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Éxons/genética , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Paraparesia Espástica/diagnóstico por imagem , Paraparesia Espástica/patologia , Linhagem , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
INTRODUCTION: In recent years there has been an increase in the number of endovascular examinations in the study of both cardiovascular and cerebrovascular diseases. One very infrequent complication is neurotoxicity due to contrast, and it must be suspected within the context of a neurological deficit following such examinations in order to be able to diagnose it. CASE REPORT: A 61-year-old male who presented an epileptic attack and later deficit in the left hemisphere following diagnostic arteriography. After ruling out the possibility of an urgent vascular pathology, he was submitted to a magnetic resonance brain scan with the suspicion of this condition. The clinical signs and symptoms were limited to 72 hours with cortisone therapy. CONCLUSIONS: Contrast-induced encephalopathy covers a wide range of clinical features which, in the vast majority of cases, are self-limiting to 24-72 hours, and within the context of neuronal damage following contrast infusion. Its prognosis is excellent, and diagnostic suspicion is crucial in its treatment.
TITLE: Encefalopatia por contraste iodado: una patologia que se debe tener en cuenta en el desarrollo de las exploraciones endovasculares.Introduccion. En los ultimos años ha aumentado el numero de exploraciones endovasculares en el estudio de la patologia tanto cardiovascular como cerebrovascular. Una de las complicaciones poco frecuentes es la neurotoxicidad por contraste y su sospecha resulta imprescindible en el contexto de un deficit neurologico tras dichas exploraciones para llegar a su diagnostico. Caso clinico. Varon de 61 años que tras una arteriografia diagnostica en el estudio de una hemorragia subaracnoidea presento una crisis epileptica y posteriormente deficit hemisferico izquierdo. Tras descartar una patologia vascular urgente, se realizo una resonancia magnetica cerebral con sospecha de encefalopatia poscontraste. La clinica se limito en 72 horas con corticoterapia. Conclusiones. La encefalopatia por contraste abarca un amplio espectro clinico, en la inmensa mayoria de los casos autolimitado en 24-72 horas, y en el contexto del daño neuronal tras la infusion de contraste. Su pronostico es excelente y la sospecha diagnostica es vital en el tratamiento.
Assuntos
Angiografia , Meios de Contraste/efeitos adversos , Iopamidol/efeitos adversos , Síndromes Neurotóxicas/etiologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Objetivo: Determinar el valor a-adido de los parámetros semicuantitativos en el análisis visual y estudiar los patrones del depósito cerebral de 18F-Florbetaben. Material y métodos: Análisis retrospectivo de pacientes con deterioro cognitivo leve o demencia de origen incierto procedentes de un estudio multicentrico. Los PET con 18F-Florbetaben fueron interpretados de forma visual por dos observadores independientes, analizando las regiones diana con la finalidad de calcular el acuerdo interobservador. Se realizó análisis semicuantitativo de todas las regiones corticales con respecto a tres regiones de referencia para obtener índices de captación (SUVRs). Se analizó la capacidad de los SUVRs para predecir el resultado de la interpretación visual, la posibilidad de depósito preferencial del radiotrazador en algunas regiones diana así como las diferencias interhemisféricas. Resultados: Se evaluaron 135 pacientes. En la valoración visual, 72 estudios se clasificaron como positivos. El acuerdo interobservador fue excelente. Todos los SUVRs fueron significativamente superiores en pacientes con PET positivos con respecto a los negativos. Las regiones corticales correspondientes al área prefrontal y al cingulado posterior mostraron la mejor correlación con la evaluación visual, seguidas por la valoración integrada cortical. Usando análisis de ROC, los SUVRs obtenidos en las mismas regiones diana mostraron la mejor capacidad diagnóstica. Conclusiones: La información obtenida de las regiones diana parece ser de ayuda en la clasificación visual, basado en un depósito preferencial de amiloide, lo que permitiría el machine learning. El depósito de amiloide, aunque difuso en todas las regiones corticales, parece no ser uniforme ni simétrico (AU)
Aim: To assess the added value of semiquantitative parameters on the visual assessment and to study the patterns of 18F-Florbetaben brain deposition. Materials and methods: Retrospective analysis of multicenter study performed in patients with mild cognitive impairment or dementia of uncertain origin. 18F-Florbetaben PET scans were visually interpreted by two experienced observers, analyzing target regions in order to calculate the interobserver agreement. Semiquantification of all cortical regions with respect to three reference regions was performed to obtain standardized uptake value ratios (SUVRs). The ability of SUVRs to predict the visual evaluation, the possibility of preferential radiotracer deposition in some target regions and interhemisphere differenceswere analyzed. Results: 135 patients were evaluated. In the visual assessment, 72 were classified as positive. Interobserver agreement was excellent. All SUVRs were significantly higher in positive PET scans than in negative ones. Prefrontal area and posterior cingulate were the cortical regions with the best correlations with the visual evaluation, followed by the composite region. Using ROC analysis, the SUVRs obtained in same target locations showed the best diagnostic performance. Conclusions: The derived information from target regions seems to help the visual classification, based on a preferential amyloid deposit, allowing machine learning. The amyloid deposit, although diffuse in all cortical regions, seems not to be uniform and symmetric (AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Doença de Alzheimer/diagnóstico por imagem , Peptídeos beta-Amiloides , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Estudos Retrospectivos , Aprendizado de MáquinaRESUMO
INTRODUCTION: Chronic progressive external ophthalmoplegia (CPEO) is a common mitochondrial disease. The different conditions in this group of diseases overlap clinically, enzymatically and genetically. There is no effective treatment. Ptosis improves with corrective surgery involving tarsorrhaphy as a palliative measure. CASE REPORTS: Code numbers were examined in a retrospective study conducted in order to search for patients with ptosis or ophthalmoplegia who had either visited or been admitted to the neurology department over the last 10 years. Data concerning these patients' clinical features and results of complementary tests were collected. Six patients with CPEO were identified, five of whom were females. Ages ranged from 44 to 72 years. All the patients had ptosis, although 50% were asymmetric. Half of them reported mild dysphagia while swallowing liquids. Levels of creatine phosphokinase and acetylcholine antireceptor antibodies were normal. Half the patients showed increased jitter and a muscle biopsy revealed that five of them had ragged red fibres. The most frequent enzyme deficit was complex I and IV deficiency. There were no familial forms; the most common genetic anomaly was single deletion in the mitochondrial deoxyribonucleic acid. CONCLUSIONS: In cases of ptosis and ophthalmoplegia that do not respond to anticholinesterases, knowledge of this condition makes it possible to avoid the use of immunosuppressant drugs, which have important side effects.
Assuntos
Oftalmoplegia Externa Progressiva Crônica/fisiopatologia , Adulto , Idoso , Biópsia , Blefaroptose/etiologia , Complexos Cardíacos Prematuros/etiologia , Deficiência de Citocromo-c Oxidase/complicações , Deficiência de Citocromo-c Oxidase/diagnóstico , Transtornos de Deglutição/etiologia , Eletromiografia , Complexo I de Transporte de Elétrons/análise , Complexo IV da Cadeia de Transporte de Elétrons/análise , Feminino , Bloqueio Cardíaco/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Mitocôndrias Musculares/enzimologia , Mitocôndrias Musculares/patologia , Fibras Musculares de Contração Rápida/patologia , Músculos Oculomotores/patologia , Oftalmoplegia Externa Progressiva Crônica/epidemiologia , Oftalmoplegia Externa Progressiva Crônica/genética , Estudos Retrospectivos , Espanha/epidemiologiaRESUMO
INTRODUCTION: Horner syndrome (HS) is produced by damage to the oculosympathetic pathway and gives rise to palpebral ptosis, enophthalmos and myosis. Anhidrosis also occurs in cases in which the lesion is located before the separation of the vasomotor and sudomotor fibres at the start of the internal carotid artery. Nasopharyngeal cancer may damage the cranial nerves, mainly in the cavernous sinus, and very few cases of HS due to infiltration of the tumour into the parapharyngeal space have been reported. CASE REPORTS: Case 1: a 67-year-old male with a 10-day history of HS on the left side without anhidrosis. The aetiological study revealed a nasopharyngeal lymphoepithelioma; the tumour became smaller and HS disappeared following treatment with chemotherapy. Case 2: a 48-year-old male with a 1-week history of HS without anhidrosis, and a 2-month history of deafness and pain in the right ear. The aetiological study showed a nasopharyngeal lymphoepithelioma and serous otitis. The tumour became smaller and HS disappeared following treatment with chemotherapy. CONCLUSIONS: It is important to carry out studies of the nasopharynx in patients with this syndrome to allow early diagnosis and treatment of a region that is not readily available for direct examination. The existence of an associated pathology in the ear or the paranasal sinuses strongly suggests that its origins lie in the nasopharynx.
Assuntos
Síndrome de Horner/etiologia , Neoplasias Nasofaríngeas , Idoso , Carcinoma/complicações , Carcinoma/diagnóstico , Carcinoma/patologia , Síndrome de Horner/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Nasofaríngeas/complicações , Neoplasias Nasofaríngeas/diagnóstico , Neoplasias Nasofaríngeas/patologia , Tomografia Computadorizada por Raios XRESUMO
INTRODUCTION: Tolosa-Hunt syndrome is caused by an unspecific inflammation in the cavernous sinus or superior orbital fissure. Recurrence occurs in 40% of cases. Magnetic resonance (MR) of the head and orbital phlebography can reveal characteristic data, although diagnosis is reached by exclusion according to International Headache Society criteria. Corticoids are the preferred treatment, since their use gives rise to the disappearance of the clinical condition in a few days. CASE REPORT: We describe the cases of three patients with recurrent Tolosa-Hunt syndrome and MR images of the head with normal contrast. Case 1: a 52-year-old male with paralysis of the oculomotor nerve with recurrence on the contralateral side. Case 2: a 42-year-old female with recurrent paralysis of the abducent nerve. Case 3: a 34-year-old male with involvement of the oculomotor nerve, optic nerve and the first branch of the trigeminal nerve with recurrence of the ophthalmoplegia. In all cases the clinical symptoms disappeared with the use of corticoid therapy. CONCLUSIONS: The oculomotor disorder is produced by nerve infiltration and not by compression. The time for recurrence varies largely, and the clinical condition in the recurrence is usually milder owing to the fact that diagnosis is reached and treatment is started earlier. The absence of alterations in the MR of the head does not rule out the existence of Tolosa-Hunt syndrome, even in cases of recurrence, and these disorders therefore should not be included in the diagnostic criteria.
Assuntos
Síndrome de Tolosa-Hunt/patologia , Síndrome de Tolosa-Hunt/prevenção & controle , Corticosteroides/uso terapêutico , Adulto , Nervos Cranianos/patologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Recidiva , Síndrome de Tolosa-Hunt/diagnóstico , Síndrome de Tolosa-Hunt/tratamento farmacológicoRESUMO
INTRODUCTION: Parotiditis is a viral infection that produces a non-suppurative inflammation of the parotid glands, although it may affect other salivary glands, the testicles, meninges and the pancreas. Clinical meningitis appears in 1-10% of cases, normally between the 4th and the 10th day after infection of the parotid glands. In this study, we analyse the clinical and analytic characteristics of the patients admitted to our Neurology Department over the last 12 years. CASE REPORTS: A retrospective study was conducted by analysing the hospital discharge reports. The eligibility criterion was the existence of an acute meningeal syndrome linked to the presence of positive IgM titres for the parotiditis virus. In all, 13 cases were found, with a mean age of 16.5 years, and most of them were males (92.3%). Parotiditis preceded meningitis in all our patients with an average of 8.3 days, while orchiepididymitis, when it occurred, appeared at the same time or after meningitis. Analysis of the cerebrospinal fluid showed a lymphocyte profile with glycorrhachia above 40%, except in two cases that showed a non-persistent neutrophilic profile. There was a transient 30.7% reduction in prothrombin time in the patients. No sequelae were observed. CONCLUSIONS: Vaccination campaigns have drastically reduced the number of cases of meningitis due to this germ since the second half of the 90s. This virus must be borne in mind in cases of meningitis in young males who come from underdeveloped countries.
Assuntos
Meningite/epidemiologia , Caxumba/epidemiologia , Adolescente , Área Programática de Saúde , Epididimite/epidemiologia , Epididimite/etiologia , Feminino , Humanos , Masculino , Meningite/líquido cefalorraquidiano , Meningite/prevenção & controle , Caxumba/complicações , Vacina contra Caxumba , Neurologia , Orquite/epidemiologia , Orquite/etiologia , Parotidite/epidemiologia , Parotidite/prevenção & controle , Parotidite/virologia , Estudos Retrospectivos , Espanha/epidemiologiaRESUMO
BACKGROUND: To assess the prevalence of dementia and its subtypes in a population with a low level of education, and to determine whether there is any association between occupation, education and dementia. SUBJECTS AND METHOD: Cross-section study of the population, with a sample of 3,214 individuals representative of the population of Toledo, Spain, aged 65 years and older. The Mini-Mental State Examination (MMSE) was used in the first phase of the study to detect those individuals with cognitive deterioration. The second phase consisted of a semi-structured clinical interview and neuropsychological evaluation. Dementia and sub-types of dementia were determined using well-established diagnostic criteria. The process was applied using an algorithm to optimise diagnostic agreement. RESULTS: The overall prevalence of dementia, Alzheimer's disease and vascular dementia amounted to 7.6, 4.6 and 1.8%, respectively. A direct relationship was detected between these three entities and age. The prevalence of dementia was greater in women, illiterate persons and occupations which require less skill. Once adjustment had been made for other socio-demographic variables, only age was associated with the presence of dementia. CONCLUSIONS: The overall prevalence of dementia, Alzheimer's type dementia and vascular dementia increases with age. No clear association was found between education, occupation and dementia.
Assuntos
Demência/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Demência/classificação , Escolaridade , Feminino , Humanos , Masculino , Ocupações , Prevalência , EspanhaRESUMO
INTRODUCTION: The implementation of an on-call neurology service at our hospital prompted us to analyse the health care it offers. PATIENTS AND METHODS: We conducted a retrospective descriptive study by reviewing the status report of the on-call services performed between 15 April 2002 and 14 April 2003. The data collected included the age, sex, day of the week, month, requesting service, destination and pathology grouped under different codes to facilitate their later analysis. RESULTS: A total of 1910 patients were attended with a mean age of 53 and with no differences between sexes. The service that most often requested evaluation was casualty with over 80% of cases. The most frequently involved pathologies were headaches (19.7%), followed by ischemic strokes (16.1%) and epilepsy (13.4%). In 12.3% of cases no neurological pathology was observed. The percentage of direct hospital discharges was 29.16%, while that of admissions to neurology was lower (23.56%). Patients requiring further follow-up visits to Neurology were remitted normally (12.56%), compared to those who were in need of preferential treatment (4.45%). CONCLUSIONS: The need for a duty neurologist has provided our hospital with a better evaluation of neurological pathologies and a more rational use of complementary tests. Many of the patients who were evaluated were given a direct hospital discharge. This has led to a drop in the number of admissions to Neurology by almost 30% and a reduction in the mean length of time spent in hospital.
Assuntos
Atenção à Saúde , Serviços de Saúde , Hospitais , Neurologia , Padrões de Prática Médica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/terapia , Admissão do Paciente , Alta do Paciente , Estudos Retrospectivos , Recursos HumanosRESUMO
INTRODUCTION: Transient global amnesia is a syndrome mainly characterised by an anterograde memory deficit, which disappears in less than 24 hours without leaving any kind of sequelae. Its aetiopathogenesis is still unclear. The ischemic theory became important after hypoperfusion was observed in the mesial region of the temporal lobe using different imaging techniques, although recently the use of diffusion-weighted magnetic resonance imaging by other authors has not revealed these alterations in the cerebral blood flow. CASE REPORT: We report on a transcranial Doppler study carried out in a female patient during the acute phase of the amnesia, with no evidence of hemodynamic alterations or significant asymmetries. Repeating the test after clinical recovery offered values that were similar to those of the previous study. CONCLUSIONS: It is posited that the basis of this process would not be related to ischemia but instead to a mechanism enabling spreading neurogenic depression that is similar to that which takes place during a migraine attack. Treatment with antiplatelet drugs would not, therefore, be recommended but calcium antagonists or beta blockers would be useful in preventing the clinical picture from being repeated.
Assuntos
Amnésia/diagnóstico por imagem , Ultrassonografia Doppler Transcraniana , Idoso , Feminino , HumanosAssuntos
Cervicalgia/diagnóstico , Doenças da Língua/diagnóstico , Adolescente , Vértebras Cervicais/patologia , Criança , Feminino , Humanos , Cervicalgia/etiologia , Cervicalgia/patologia , Cervicalgia/fisiopatologia , Síndrome , Língua , Doenças da Língua/etiologia , Doenças da Língua/patologia , Doenças da Língua/fisiopatologiaAssuntos
Antipsicóticos/efeitos adversos , Coreia/induzido quimicamente , Dibenzotiazepinas/efeitos adversos , Síndrome de Abstinência a Substâncias , Idoso , Antipsicóticos/uso terapêutico , Dibenzotiazepinas/uso terapêutico , Feminino , Humanos , Doença de Parkinson/tratamento farmacológico , Fumarato de QuetiapinaAssuntos
Tumor Glômico/patologia , Doenças do Nervo Hipoglosso/patologia , Idoso , Estudos de Avaliação como Assunto , Feminino , Tumor Glômico/complicações , Tumor Glômico/diagnóstico , Humanos , Doenças do Nervo Hipoglosso/diagnóstico , Doenças do Nervo Hipoglosso/etiologia , Imageamento por Ressonância Magnética , SíndromeRESUMO
INTRODUCTION: Pharmaceutical preparations with the capacity to block dopamine receptors at the brain level quite often cause secondary movement disorders, but are not the only cause. These movement disorders can be due to a poor or difficult capacity to carry out movements similar to the type observed in idiopathic Parkinson's disease (parkinsonism secondary to drugs) or also because of excess movement with acute or chronic dystonic or choreic clinical pictures. Why the same drugs cause apparently opposing effects is not altogether clear, although it is supposed that individual factors related to the pharmacokinetics, pharmacodynamics and sensitivity of different types of sub-receptors play a crucial role. DEVELOPMENT: We describe the most frequent groups of symptoms, divided into two parts depending on whether the disorder is hyper- or hypokinetic, and the drugs that are most commonly responsible for those clinical pictures are also discussed. The most frequent disorders caused by excessive movement are acute dyskinesia, akathisia and tardive dyskinesia. The disorder caused by scarcity of movement is a parkinsonian picture that it may be impossible to distinguish from idiopathic Parkinson's disease. CONCLUSIONS: An awareness of the possible existence of these disorders is essential for the clinical suspicion and diagnosis. On most occasions, withdrawing the causing drug reverts the symptoms without the need for complicated or costly diagnostic studies.
Assuntos
Discinesia Induzida por Medicamentos , Diagnóstico Diferencial , Dopaminérgicos/efeitos adversos , Dopaminérgicos/uso terapêutico , Discinesia Induzida por Medicamentos/tratamento farmacológico , Discinesia Induzida por Medicamentos/etiologia , Discinesia Induzida por Medicamentos/fisiopatologia , HumanosRESUMO
Introducción: La paquimeningitis hipertrófica es un proceso poco frecuente en la población general, y mucho menos aún en la población pediátrica. Actualmente se está estudiando una posible base inmunológica, con las consiguientes implicaciones en su tratamiento. Caso clínico: Se expone el caso de una paciente de 13 años de edad, con cefalea y afectación de los pares craneales con dicho diagnóstico, establecido mediante pruebas de imagen, y coexistencia de anticuerpos antineutrófilo citoplasmático con patrón mieloperoxidasa, con todo el estudio de extensión negativo. Conclusión: El diagnóstico de dicha patología y su relación con la etiología autoinmune, aunque es poco frecuente, debe considerarse, ya que las implicaciones en cuanto al tratamiento, pronóstico y evolución son muy importantes
Introduction: Hypertrophic pachymeningitis is an uncommon process in the population at large, and even less common among the paediatric population. A possible immunological basis is currently being studied, with the consequent implications for its treatment. Clinical case study: The case described is that of a 13 year-old patient with headache and affected cranial nerves with the said diagnosis, reached through imaging tests and the coexistence of cytoplasmic anti-neutrophil antibodies with a myeloperoxidase pattern, with the extension study entirely negative. Conclusion: Diagnosis of the said pathology and its link with autoimmune aetiology, while infrequent, must be taken into consideration, as the implications for treatment, prognosis and development are considerable