A Case of Hypertrophic Pachymeningitis With Prolonged Headache, Attributable to Epstein–Barr Virus


  • Hirohisa Okuma MD,

  • Satoko Kobori MD,

  • Yukito Shinohara MD,

  • Shigeharu Takagi MD

  • From the Department of Neurology, Tokai University Tokyo Hospital, Tokyo, Japan.

Address all correspondence to Dr. Hirohisa Okuma, 1–2–5 Shibuya-ku Yoyogi, Tokyo 151-0053, Japan.


Hypertrophic pachymeningitis is a condition characterized by significant chronic inflammatory thickening of the cranial dura mater, frequently presenting with symptoms such as headache and cranial neuropathy. In this report, we describe a very rare case of hypertrophic pachymeningitis, considered to be attributable to Epstein–Barr virus (EBV), which was diagnosed in a patient who visited our hospital with a complaint of ongoing severe headaches. The diagnosis was based on positive specific serum EBV antibody titers, with VCA-IgM levels of less than 1:10, VCA-IgG levels of 1:160, and EBNA levels of 1:40, as well as on the results of magnetic resonance imaging of the head with contrast media.