BMJ Case Reports 2012; doi:10.1136/bcr-2012-006471
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Cranial neuropathy because of IgG4-related pachymeningitis; intracranial and spinal mass lesions

  1. Yasunori Mito
  1. Department of Neurology, Sapporo City General Hospital, Brain Health Center, Sapporo, Japan
  1. Correspondence to Dr Yasutaka Tajima, yasutaka.tajima{at}


A 64-year-old man suffering from chronic heart failure developed gradually worsening dysphagia 1 month before. Physical examinations revealed no abnormalities, such as proptosis and parotid swelling. Neurological examinations revealed hoarseness, poor soft palate elevation and right-sided atrophy of the tongue and sternocleidomastoid muscle. The patient's DTRs were slightly hypoactive, but no pathological reflexes were elicited. Cerebellar systems were intact, …

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