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Isolated "one and a half syndrome" with brainstem tuberculoma
Vimla Menon1, Madhurjya Gogoi, Rohit Saxena
1Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Indian Journal of Pediatrics
|May 28, 2004
Summary
This case report details a rare association between a brainstem tuberculoma and One and a half syndrome in a child. Treatment with anti-tubercular drugs led to full recovery and lesion resolution.
Area of Science:
- Neurology
- Infectious Diseases
- Pediatrics
Background:
- Tuberculomas, granulomatous infections caused by Mycobacterium tuberculosis, can affect the central nervous system.
- One and a half syndrome is a rare conjugate gaze palsy involving ipsilateral internuclear ophthalmoplegia and ipsilateral horizontal gaze palsy.
Observation:
- A 12-year-old girl presented with symptoms suggestive of One and a half syndrome.
- Magnetic Resonance Imaging (MRI) revealed an isolated tuberculoma within the brainstem.
Findings:
- Empirical treatment with anti-tubercular drugs was initiated for the brainstem lesion.
- The patient experienced complete restoration of ocular motility following treatment.
- Follow-up MRI at 6 months confirmed resolution of the brainstem tuberculoma.
Implications:
- This case highlights a rare causal link between brainstem tuberculomas and One and a half syndrome.
- Early diagnosis and appropriate anti-tubercular therapy are crucial for favorable outcomes in such cases.
- The findings underscore the importance of considering tuberculosis in the differential diagnosis of pediatric brainstem lesions presenting with ocular motility deficits.
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