de La Blanchardière A, Stern J B, Molina J M, Lesprit P, Gasnault J, de Kerviler E, Decazes J M, Modai J
Clinique des Maladies infectieuses et tropicales, Hôpital Saint-Louis, Paris.
Presse Med. 1996 Oct 5;25(29):1333-5.
Tuberculous arachnoiditis of the spine is a rare complication of tuberculous meningitis and can occur despite correct treatment. We report two cases of arachnoiditis in patients with tuberculous meningitis. In both cases, clinical signs included flaccid paraparesia and sphincter dystonia. Evidence for diagnosis was obtained with magnetic resonance imaging of the lombosacral spine after a 3 or 11 week course. Adding corticosteroids to the anti-tuberculosis therapy provided spectacular clinical improvement within 8 days in both cases. The diagnosis of tuberculous arachnoiditis of the spine is often made late but can be confirmed easily with magnetic resonance imaging. Our cases emphasize the importance of oral corticosteroid therapy to avoid severe sequellae.
脊柱结核性蛛网膜炎是结核性脑膜炎的一种罕见并发症，即使治疗正确也可能发生。我们报告两例结核性脑膜炎患者发生蛛网膜炎的病例。两例患者的临床体征均包括弛缓性截瘫和括约肌张力障碍。在病程3周或11周后，通过腰骶部脊柱磁共振成像获得诊断依据。在抗结核治疗中加用皮质类固醇激素后，两例患者均在8天内出现显著的临床改善。脊柱结核性蛛网膜炎的诊断通常较晚，但磁共振成像可轻易确诊。我们的病例强调了口服皮质类固醇激素治疗以避免严重后遗症的重要性。
