一种罕见的肺结核并发症：急性截瘫。
A Rare Complication of Tuberculosis: Acute Paraplegia.
作者信息
Aydın Teoman, Taşpınar Özgür, Keskin Yasar, Kepekçi Müge, Güneşer Meryem, Çamlı Adil, Seyithanoğlu Hakan, Kızıltan Huriye, Eriş Ali Hikmet
机构信息
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bezmi Alem Vakıf University, İstanbul.
Department of Physical Medicine and Rehabilitation, Cınarcik State Hospital, Yalova.
出版信息
Ethiop J Health Sci. 2016 Jul;26(4):405-7. doi: 10.4314/ejhs.v26i4.14.
BACKGROUND
Tuberculous radiculomyelitis(TBRM) is one of the complications of neurological tuberculosis and includes cases of arachnoiditis, intradural spinal tuberculoma or granuloma, and spinal cord complications of tuberculous meningitis (TBM). Here, we report a case of TBRM which presented with acute paraplegia.
CASE DETAILS
Neurological examination on admission revealed flaccid paralysis, bilateral extensor plantar responses, and exaggerated deep tendon reflexes. Cerebrospinal fluid analysis showed xanthochromic fluid that contained 600 cells/mm3, 98% lymphocytes, protein 318 mg/dl and glucose 51 mg/dl (blood glucose 118 mg/dl). On thorax CT, calcified lymph nodes that were sequelae of primary tuberculosis infection was detected. Antituberculosis and intravenous corticosteroids treatment was started. Seven weeks from the onset, on-control spinal MRI myelomalacia was determined, and there was no leptomeningeal enhancement. After six weeks of rehabilitation, lower limb total motor score was increased from 0/50 to 15/50.
CONCLUSIONS
Tuberculous radiculomyelitis is a complication of TBM. It is rarely seen.
背景
结核性脊神经根脊髓炎（TBRM）是神经结核的并发症之一，包括蛛网膜炎、硬脊膜内脊髓结核瘤或肉芽肿以及结核性脑膜炎（TBM）的脊髓并发症。在此，我们报告一例表现为急性截瘫的TBRM病例。
病例详情
入院时神经检查显示弛缓性瘫痪、双侧伸性跖反射和亢进的深腱反射。脑脊液分析显示为黄色脑脊液，细胞计数为600个/mm³，98%为淋巴细胞，蛋白质318mg/dl，葡萄糖51mg/dl（血糖118mg/dl）。胸部CT检查发现有钙化淋巴结，为原发性结核感染的后遗症。开始进行抗结核和静脉注射皮质类固醇治疗。发病7周后，复查脊髓MRI显示脊髓软化，无软脑膜强化。经过6周的康复治疗，下肢总运动评分从0/50提高到15/50。
结论
结核性脊神经根脊髓炎是TBM的一种并发症。它很少见。
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