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Isolated thalamic tuberculoma presenting as ataxic hemiparesis
Ritesh Sahu1, Tushar B Patil, Prakash Kori
1Department of Neurology, King George's Medical University, Lucknow, Uttar Pradesh, India.
BMJ Case Reports
|April 13, 2013
Summary
Thalamic tuberculoma is a rare cause of ataxic hemiparesis (AH), a lacunar syndrome. This case report details a patient with AH successfully treated with antitubercular therapy.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Lacunar syndrome results from deep cerebral lesions, often due to microatheroma.
- Ataxic hemiparesis (AH) is a lacunar syndrome characterized by unilateral weakness and ipsilateral ataxia.
Observation:
- An elderly male presented with left hemiparesis and ipsilateral ataxia.
- Clinical findings included left upper motor neuron facial paresis, left hemiparesis, and left-sided incoordination.
- Diagnostic tests revealed a positive Mantoux test and elevated erythrocyte sedimentation rate.
Findings:
- Brain MRI demonstrated a right thalamic lesion consistent with tuberculoma, showing specific signal intensities and perilesional edema.
- This presentation is the first reported instance of thalamic tuberculoma causing ataxic hemiparesis.
Implications:
- Highlights the importance of considering tuberculosis in the differential diagnosis of thalamic lesions presenting as ataxic hemiparesis.
- Successful treatment with antitubercular therapy suggests this is a viable therapeutic approach for this rare condition.
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