Pachymeningitis: Anyone else?

hi ..just wondering how you are getting on .Hoping you got some positive news .
Meg

Is this forum still open?

Hi @gigirambo and welcome to Connect. Indeed, this forum is still open. Have you been diagnosed with pachymeningitis?

Yes, Was diagnosed first of April. Had been suffering with headaches that became more and more severe. My internist prescribed a CT scan and immediately sent me to the ER. A lumbar puncture was done and I was admitted into the hospital for more testing. Had MRIs - with & without contrast- and was started on antiviral meds as they weren't sure what my diagnosis might be. After release from the hospital, I was prescribed steroids for approximately 2 weeks and referred to Emory Hospital in Atlanta, Ga for further testing. Met with a Neurologist there that wanted all MRIs done once again....and concurs with the original diagnosis of Pachymeningitis.
Headaches have lessened in severity and manageable with OTC meds ( but can't lean over as pain becomes severe) I am to return to Emory in 3 months to have MRIs repeated. My question is what should I be doing to lessen the chance of this getting worse again and if diet, supplements, etc might help in treatment? I understand that there is not much info on this condition, but feeling like I'm on a roller coaster. Dr.s have told me to take it easy and rest over the next several months and avoid stress as much as possible. Trying !

@gigirambo how are you feeling? Are your B cells very high? For me the steroids helped but the rituximab Infusions x4 has really reduced the inflammation in the dura. So far I’m doing okay and next MRI will be in January. My neurologist says I may not need another rituximab infusion depending on the results and how I’m feeling. I still get occasional shooting pains in my face and eye area but last a few seconds. My eyes are very dry so I use drops a few times per day. So far doing well. Let me know if you have any other specific questions.

So sorry for u both. My hubby got diagnosed with pachymeningitis 2 weeks ago. Ruled out cancer & autoimmune probs. Am going back to specialists soon to find out if addl blood tests showed the cause. On 20mg/day Prednisone for now. Will get back with u. Thx!

See post below.

Hi @grand7jud
We are here for you and your hubby if you have any questions. The prednisone should start helping. I was started on prednisone 60mg and tapered down to 5mg for about 6-8 weeks. However I have type 2 diabetes so being on prednisone long term was not an option. Symptoms of facial numbness and shooting pains started again after I finished the prednisone treatment. So my doctor recommended Rituximab Infusions which has helped tremendously. I’ve had two sets of Rituximab Infusions so far and having an MRI in January. I’m not sure if I will need another set of Infusions because I’m feeling okay so far. Last one was a year ago. We are here for you and available to assist in anyway. It’s very difficult to go through this feeing alone since it’s so rare.

Hi @grand7jud and @jrt26 @gigirambo ....Good to hear positive results with rituximab @jrt26 .I hope everyone else is getting on ok .It's a weird one having something so rare I think I found that as tough as the pachymeningitis! .....I had a set back a few weeks ago my neurologist was on holiday ,.I went to my gp (doctor) had to explain to the best of my knowledge what I have ,then she asks me what do i think we should do ??? ... sums it up really for me pretty lonely .
I've had a year of steroids more or less now and mycophenolate although I haven't had complete resolution ,my head is a lot better than it was .I had developed severe oedema(amongst other things) in my left inferior frontal lobe but huge doses of steroids sorted that ... I'm on a super slow taper of steroids after a failed attempt and a blip were my head headaches came back with avengence ...it will nice to recognise myself in the mirror again ! Steroids have induced cushings syndrome and I hate them yet i am grateful for them....I still have rubbish eyes bit of intermittent double vision ...the Neurologist thinks that it's possibly nerve damage rather than active disease...but he admits it's all a bit of " if but and maybe " .but things are better than they were.hey hoe.Hope everything goes well for you all Meg

An update. I posted above that my IHCP was diagnosed in Feb, 2017 by a MRI. Had a followup MRI 5 months later in July, 2017, and it showed no progression, so my neurologist and I decided on a wait and see approach because my symptoms were relatively mild and not warranting the steroid treatment side effects. I should have posted earlier this year again that another MRI was done in July, 2018. Fortunately it again showed no change (IHCP stabilized), so again no treatments. We will just continue this program unless there is progression. It frustrating to know that if there is progression, I will have to start with the steroids first knowing that they likely will do no good before I can be treated with rituximab, but it's nice knowing that there is a likely cure.