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Isolated brain stem tuberculoma presenting with one and a half syndrome
Mushira Enani1, Daifallah J Al-Nakhli, Eman Bakhsh
1Department of Medicine, Division of Infectious Diseases, Riyadh Military Hospital, PO Box 7897, Riyadh 11159, Kingdom of Saudi Arabia. mushirae@yahoo.com
Saudi Medical Journal
|September 5, 2006
Summary
A rare one-and-a-half syndrome caused by a brainstem tuberculoma was successfully treated with anti-tuberculosis therapy. This case highlights the importance of considering tuberculosis in patients with brainstem lesions and this specific neurological syndrome.
Area of Science:
- Neuro-ophthalmology
- Infectious Diseases
- Neurology
Background:
- The one-and-a-half syndrome is a rare neurological condition characterized by conjugate gaze palsy and ipsilateral internuclear ophthalmoplegia.
- Brainstem lesions are a common cause, but the etiology can be diverse.
Observation:
- A patient presented with left conjugate gaze palsy and right internuclear ophthalmoplegia, consistent with the one-and-a-half syndrome.
- Brain magnetic resonance imaging revealed nodular enhancing lesions in the brainstem.
Findings:
- Tuberculoma was identified as the cause after excluding other potential pathologies.
- The patient showed significant recovery 8 weeks after commencing anti-tuberculosis (anti-TB) treatment.
Implications:
- This case underscores the potential for isolated brainstem tuberculomas to manifest as the one-and-a-half syndrome.
- Early diagnosis and treatment of neurotuberculosis are crucial for favorable neurological outcomes.
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