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[Tuberculous meningitis. One case: ophthalmic complications].

M J Pérez Alvarez1, M Moreno López, Mar González Manrique

  • 1Hospital Universitario de Guadalajara, Spain. mjperezalv@hotmail.com

Archivos De La Sociedad Espanola De Oftalmologia
|December 4, 2004
PubMed
Summary

Tuberculous meningitis can cause severe neurological deficits, including vision loss and cranial nerve palsies. This case highlights a rare instance of tuberculous meningitis with a favorable outcome despite significant initial symptoms.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Ophthalmology

Background:

  • Tuberculous meningitis (TBM) is a serious infection of the central nervous system.
  • Basal arachnoiditis is a potential complication of TBM, often associated with poor prognosis.
  • Neurological deficits, including visual impairment and cranial nerve palsies, are common in advanced TBM.

Observation:

  • A case report of an 18-year-old female with tuberculous meningitis is presented.
  • The patient exhibited bilateral amaurosis (vision loss), ophthalmoplegia (eye movement paralysis), multiple cranial nerve palsies, and loss of consciousness.
  • This constellation of symptoms indicates severe neurological involvement.

Findings:

  • Tuberculous meningitis is identified as a rare etiology of basal arachnoiditis.

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  • The prognosis for basal arachnoiditis secondary to TBM is typically poor.
  • The case details the potential causes for visual acuity loss and ophthalmoplegia in this context.

    • Implications:

    • Despite the severe presentation and poor prognosis associated with TBM-induced basal arachnoiditis, a favorable outcome is possible.
    • This case underscores the importance of considering TBM in patients with unexplained neurological and ophthalmological deficits.
    • Early diagnosis and appropriate treatment may lead to recovery without lasting sequelae, even in severe cases.