Tubercular Rhombencephalitis

Tomar, Laxmikant Ramkumarsingh; Shah, Drashti; Agarwal, Poojan; Rohatgi, Anshu; Agrawal, Chandra Shekhar

doi:10.4103/aian.aian_685_20

Cited by 3 publications

(4 citation statements)

References 8 publications

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“…Rhombencephalitis is defined as inflammatory diseases affecting rhombencephalon or the hind brain, which is composed of brainstem and cerebellum. [1][2][3][4][5] It was first described by Edwin Bickerstaff and Philip Cloake in 1951. 12 It can be due to multiple etiologies broadly divided into infectious, autoimmune and paraneoplastic causes.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Tuberculous rhombencephalitis is rare and accounts for 2% of cases of rhombencephalitis. 4,5 Even in developing countries endemic for tuberculosis, it is an uncommon presentation and comprises only 2.5-8% of intracranial tuberculomas. [6][7][8][9] Here we describe a case of tuberculous rhombencephalitis in a 57-year-old female, who presented with a sensory dermatomal level in trunk resembling spinal cord pathology.…”

Section: Introductionmentioning

confidence: 99%

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Tuberculous rhombencephalitis presenting with pseudo-spinal pattern of sensory loss

Aravind

Velayudhan²,

Abdulkhayarkutty³

et al. 2022

IJN

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Tuberculous rhombencephalitis is an uncommon presentation of intracranial tuberculosis. A 57 year old female, presented with central positional vertigo and features of left 5 and 7 cranial nerve palsy, with a sensory dermatomal level to pain and temperature and diminished vibration sense on left side. On evaluation, was found to have multiple discrete and conglomerate ring enhancing lesions in pons with normal MRI of spine. After extensive evaluation with Magnetic Resonance Spectroscopy, Cerebrospinal fluid and blood investigations and Mantoux test, possible tuberculosis rhombencephalitis was considered and was started on antitubercular treatment, to which she responded well. Our patient had an atypical presentation with sensory level in trunk, which has not been reported in literature. Hence we describe this case and review the neuroanatomical substrates involved. A high index of suspicion is always needed, while dealing with atypical presentations.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tuberculous rhombencephalitis presenting with pseudo-spinal pattern of sensory loss

Aravind

Velayudhan²,

Abdulkhayarkutty³

et al. 2022

IJN

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“…Although the term has been used freely in the literature, only five cases that actually fit the criteria for TbE have been reported: three with limbic encephalitis, one with cerebellitis, and one with rhombencephalitis. 14,15 None of these cases underwent brain biopsy to prove the diagnosis. Although tuberculosis rhombencephalitis has been described with AIDS in a few cases, these cases mainly involved multiple brainstem tuberculomas with leptomeningeal enhancement and were not true TbE.…”

Section: Discussionmentioning

confidence: 99%

Tuberculous Encephalitis May Be Undetectable on Magnetic Resonance Imaging but Detectable on 18F-Fluorodeoxyglucose Positron Emission Tomography–Computed Tomography

Maramattom

Santhamma

2021

The American Journal of Tropical Medicine and Hygiene

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Neurotuberculosis (NT) continues to be a global health problem with severe morbidity and mortality. The manifestations of NT are well-known and encompass forms such as meningitis, tuberculomas, military tuberculosis, ventriculitis, and brain abscess. Data of all patients with central nervous system tuberculosis who underwent magnetic resonance imaging (MRI) and/or 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography–computed tomography (PET-CT) were analyzed. Over a 7-year period (2014–2021), we encountered three patients who had dense neurological deficits and 18F-FDG PET-CT results suggesting focal cortical encephalitis. 18F-FDG PET-CT demonstrated focal hypermetabolism involving focal–regional areas of the left hemisphere that corresponded to clinical deficits in two of the three patients. Follow-up 18F-FDG PET-CT showed improvement in cortical hypermetabolism in all three patients that corresponded with clinical improvement. MRI of the brain with contrast showed subtle leptomeningeal enhancement in these areas, along with other features of NT, but it could not detect cortical involvement. A literature review also revealed some previous descriptions that seemed to be consistent with tuberculous encephalitis (TbE). TbE seems to be a distinct subset of NT and may coexist with other features of NT or disseminated tuberculosis. It may be detected by 18F-FDG PET-CT even when brain MRI does not show any evident abnormality to explain a focal neurological deficit. 18F-FDG PET-CT can be considered during the evaluation and monitoring of NT to detect TbE. The presence of TbE may affect the prognosis and treatment duration of NT.

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“…It is the most common cause of paraplegia in any age group [ 67 ]. In this form, there is osteomyelitis of vertebral body and intervertebral discitis [ 68 ]. According to the site of involvement, Pott's spine can be classified as paradiscal, anterior, central, posterior and synovial types [ 53 ].…”

Section: Spinal Tuberculosis ( Fig 9 A-9d)mentioning

confidence: 99%

Magnetic resonance imaging findings in central nervous system tuberculosis: A pictorial review

Dahal,

Parajuli

2024

Heliyon

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Tubercular Rhombencephalitis

Cited by 3 publications

References 8 publications

Tuberculous rhombencephalitis presenting with pseudo-spinal pattern of sensory loss

Tuberculous rhombencephalitis presenting with pseudo-spinal pattern of sensory loss

Tuberculous Encephalitis May Be Undetectable on Magnetic Resonance Imaging but Detectable on 18F-Fluorodeoxyglucose Positron Emission Tomography–Computed Tomography

Magnetic resonance imaging findings in central nervous system tuberculosis: A pictorial review

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