Grand Rounds

Lower motor neuron facial palsy in CNS tuberculomas


Ira Shah, Drishti Tolani
Medical Sciences Department, Pediatric Oncall, Mumbai, India.

Address for Correspondence: Dr Ira Shah, 1/B Saguna, 271/B St Francis Road, Vile Parle (W), Mumbai 400056, India.


Clinical Problem:
An 8 years old boy presented with fever for 19 days with left sided upper limb monoparesis and left lower motor neuron (LMN) facial palsy for 1 day. Cerebrospinal fluid (CSF) showed 25 mg/dl proteins, 75 mg/dl sugar and no cells. MRI brain showed multiple granulomas in right thalamus, left frontal cortex, right temporal lobe and right side of medulla and pons. There was no infarct. Chest X-Ray was normal. Mantoux test was positive. He was started on antituberculous therapy (ATT) along with steroids. A month later, repeat MRI showed regression in size of parenchymal granulomas. Steroids were tapered and stopped in 4 months. After one year of therapy, his facial palsy and monoparesis had resolved and MRI showed no change as compared to previous scan. He was continued on same ATT.

How common is LMN facial palsy with CNS tuberculomas?


Previous Grand Rounds View All

C
Continued Neurological Damage in HIV Infected Despite Antiretroviral Therapy
Ira Shah, Drishti Tolani
A 13 years old HIV infected boy on ART since 6 years of age presented with progressive increase of involuntary movements of left side of body with increased tone in Sept 2011. He was diagnosed to have....
G
Granulomas in Chronic Granulomatous Disease
Ira Shah, Anmol Goyal
A 3 years old boy suffering from chronic granulomatous disease (CGD) presented with fever and cough. He was detected to have CGD at the age of 1 year 4 months in view of persistent pneumonia and a pos....
A
Acute Liver Failure due to acetaminophen toxicity - How to treat?
Ira Shah, Parth Gada
A 21 months old boy presented with fever, cough, cold for 4 days, drowsiness for 2 days and one episode of convulsion. He had been treated with oral paracetamol for the initial 2 days of fever every 4....
R
Refractory Iron Deficiency Anemia
Minhajuddin Ahmed Shweta Goyal Shweta Anand
A 10-year-old male child came to our out-patient department (OPD) for evaluation of refractory anemia. He had received adequate dietary and oral iron supplementation but still required multiple blood ....
D
Dermal swellings, joint contractures but no gingival hypertrophy
Ira Shah
An 18 month old girl born of third degree consanguineous marriage presented with gradual restriction of movements in both the limbs for 6 months. Patient had flexion contractures of both ankles, knee....
Disclaimer: The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.