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Chronic meningitis and thalamic involvement in a woman: Fabry disease expanding phenotype
  1. Olivier Lidove1,
  2. Marie-Paule Chauveheid1,
  3. Ludovic Benoist2,
  4. Jean-François Alexandra3,
  5. Isabelle Klein4,
  6. Thomas Papo5
  1. 1Department of Internal Medicine, Hôpital Bichat Claude-Bernard, Paris, France
  2. 2Department of Neurology, Hôpital Tenon, Paris, France
  3. 3Department of Internal Medicine, Hôpital Bichat Claude-Bernard, Paris, France
  4. 4Department of Radiology, Hôpital Bichat Claude-Bernard, Paris, France
  5. 5Department of Internal Medicine, Hôpital Bichat Claude-Bernard, Paris, France
  1. Correspondence to:
 Dr Olivier Lidove
 Department of Internal Medicine, Hôpital Bichat Claude-Bernard, 46 rue Henri Huchard, 75722 Paris Cedex 18, France; olivier.lidove{at}bch.aphp.fr

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Fabry disease (FD, OMIM 301 500) is a lysosomal storage disorder caused by an X-linked inborn error of glycosphingolipid catabolism, resulting from deficient activity of α-galactosidase A. It leads to accumulation of globotriaosylceramide (Gb3) in various organs. Manifestations of FD occur mostly in affected hemizygous males but also in heterozygous (carrier) females.1,2

Neurological complications in FD include CNS involvement, acroparesthesia, peripheral neuropathy, cranial nerve palsies with predominant VIIIth nerve involvement, and autonomic dysfunction.

Because a specific treatment has recently emerged, the diagnosis of FD may have a strong practical impact. Yet, enzyme replacement therapy has no proven efficacy on CNS Fabry manifestations.

We report on a woman who suffered from chronic meningitis which revealed heterozygous FD.

Case report

A 25-year-old woman was referred because of headache. Since the age of 12 years, the patient had complained of recurrent episodes of paresthesia in her four limbs, over 7–15 days, and sometimes leading to syncope. Headache started in November 2003, lasting 2–3 h everyday. In March 2004, the patient was hospitalised because her headache was unusually severe. At physical examination, hypoesthesia was affecting the left part of the body with respect to the face. C …

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