TUBERCULOUS MENINGITIS: PRESENTING AS ISOLATED COMPLETE III NERVE PALSY
Journal Title: International Journal of Medical Research & Health Sciences (IJMRHS) - Year 2013, Vol 2, Issue 4
Abstract
Tuberculous meningitis (TBM) is the most common form of central nervous system tuberculosis (TB) and has very high morbidity and mortality. TBM is a subacute disease with symptoms that may persist for weeks before diagnosis. Based on the clinical features alone, the diagnosis of TBM can neither be made nor excluded with certainty. A high clinical suspicion and vigilance is required for early diagnosis of TBM. The present case report demonstrates a patient with TB meningitis, who presented with clinical manifestation of isolated left III nerve palsy. Case: A 32 years female was hospitalized with acute onset of left sided ptosis, diplopia and mild generalized headache. Neurological examination at admission revealed isolated left III nerve palsy. CT scan and MRI of Brain showed no specific finding. Lumbar puncture was performed four days later due severe headache, low grade fever and neck rigidity. Cerebrospinal fluid (CSF) study, raised ESR and positive Montoux Test confirmed the diagnosis of TB meningitis. Since TB meningitis is a chronic disease, cranial nerve palsies are common manifestations. This case report suggests that TB meningitis should be considered as a disease of differential diagnosis for isolated III nerve palsy.
Authors and Affiliations
Laul Rohit S| Chief resident, Department of Ophthalmology, Annasaheb Chudaman Patil Memorial Medical College and Hospital, Dhule, Maharashtra, India, Corresponding author email: drlaulrs@rediffmail.com , Avhad Vinod| Chief resident Department of Medicine, Annasaheb Chudaman Patil Memorial Medical College and Hospital, Dhule, Maharashtra, India, Laul Abhishek S| Chief Resident, Pad.Dr Vithalrao Vikhe Patil Medical College, Ahmednagar, Maharshtra, India, Laul Subodh S| Chief Resident, Dhoot Hosptial, Aurnagabad, Maharasthra, India
Keywords
Related Articles
- EP ID EP11091
- DOI 10.5958/j.2319-5886.2.4.159
- Views 304
- Downloads 16
MEGALOURETHRA: A CASE REPORT
Congenital megalourethra is a rare mesenchymal anamoly of the male urethra. It is defined as dilation of the anterior urethra due to absence of development or deficiency of erectile tissue of the penis. It leads to defo...
TORCH infections susceptibility in Iraqi Patients with Multiple Sclerosis
Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system. Several disease-modifying therapies have been shown to ameliorate the disease course; however, the individual treatment response...
A STUDY ON RADIAL ARTERY IN CADAVERS AND ITS CLINICALIMPORTANCE
As the radial artery is the second most commonly used graft in coronary bypass (CABG)surgery(internal thoracic artery first most common)and for transcatheter coronary interventions (angioplasty),cardiac surgeons should...
Effect of Anti-Cholinergics with Tamsulosin for Treating Benign Prostate Hyperplasia Patients with an Overactive Bladder: A Clinico-Comparative Study
Objective: Overactive bladder (OAB) symptoms are due to detrusor over activity (DOA) which is characterized by involuntary detrusor contractions during bladder flling. It may co-exist with BOO due to benign prostate hyp...
A CASE OF SYNOVIAL LIPOMATOSIS WITH CHRONIC SYNOVITIS PRESENTING AS ACUTE KNEE PAIN
Background: Synovial lipomatosis is a rare, benign, intra-articular lipoma-like lesion characterized by villous proliferation of the synovium, most commonly affecting the knee joint. The usual presentation is long stand...