A Rare Complication of Tuberculosis Acute Paraplegia

Abstract

BACKGROUND: Tuberculous radiculomyelitis(TBRM) is one of the complications ofneurological tuberculosis and includes cases of arachnoiditis, intradural spinal tuberculoma orgranuloma, and spinal cord complications of tuberculous meningitis (TBM). Here, we report acase of TBRM which presented with acute paraplegia.CASE DETAILS: Neurological examination on admission revealed flaccid paralysis, bilateralextensor plantar responses, and exaggerated deep tendon reflexes. Cerebrospinal fluid analysisshowed xanthochromic fluid that contained 600 cells/mm3, 98% lymphocytes, protein 318 mg/dland glucose 51 mg/dl (blood glucose 118 mg/dl). On thorax CT, calcified lymph nodes that weresequelae of primary tuberculosis infection was detected. Antituberculosis and intravenouscorticosteroids treatment was started. Seven weeks from the onset, on-control spinal MRImyelomalacia was determined, and there was no leptomeningeal enhancement. After six weeksof rehabilitation, lower limb total motor score was increased from 0/50 to 15/50.CONCLUSIONS: Tuberculous radiculomyelitis is a complication of TBM. It is rarely seen.