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Case Studies | Medicine | India | Volume 11 Issue 11, November 2022 | Popularity: 4.6 / 10

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A Rare Case of Tuberculoma of Brain Presenting for the First Time as Tuberculous Longitudinally Extensive Transverse Myelitis (LETM)

Pallibharati Sahu

Abstract: Background: Longitudinally extensive transverse myelitis is an inflammatory lesion of spinal cord which involves 3 or more spinal segments. It is a rare presentation of M. Tuberculosis infection. Case description: Here is a case of 46 years old male presented with weakness of both lower limbs for 10 days and both upper limb for 7 days with a band like sensation around clavicle for 7 days and acute retention of urine for 6 days. On examination: Patient was hemodynamically stable with thin body built with BMI of 16 kg/m2 with spastic quadriparesis, bilateral plantar extensor, all deep tendon reflexes of upper and lower limbs exaggerated, loss of all modalities of sensation below c5level ,acute retention of urine, fundoscopy normal, MRI spine showing ill-defined intrinsic lesion extending from c2 to d12-l1 vertebral level, contrast MRI of brain shows multiple ring and nodular enhancing lesions suggestive of tuberculoma of brain, CSF study with low sugar and high protein content and CBNAAT positive for M. Tuberculosis. The patient was diagnosed with tuberculoma of brain with tuberculous LETM and then started on ATT and steroid and he is improving slowly. Conclusion: Our case highlights that tuberculoma of brain though a common manifestation sometimes presents with an unusual presentation like LETM which is a very rare presentation therefore tuberculosis as a cause of LETM should not be overlooked.

Keywords: Longitudinally extensive transverse myelitis (LETM), Brain Tuberculoma, Tuberculosis

Edition: Volume 11 Issue 11, November 2022

Pages: 379 - 381

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