장결핵 후 발생한 결핵성 신경근척수염 - 증례 보고 -

Abstract

Tuberculous radiculomyelitis (TBRM) is a rare complication of tuberculosis involving central and peripheral nervous system. We would describe a case with TBRM which developed after intestinal tuberculosis. He presented our hospital with nausea and weight loss. He suffered operation with impression of peritonitis. After operation, he showed confused mentality and diagnosed with tuberculous meningitis. Nevertheless the anti-tuberculous medication and steroid therapy, symptoms progressed to incomplete paralysis of both upper extremities and complete flaccid paralysis of both lower extremities with muscle wasting, root pain, paraesthesia, and bladder disturbance. Deep tendon reflexes were not checked. Through the MRI and electrophysiologic studies, we diagnosed him as TBRM. After conservative therapy including antituberculous medication for 12 months and comprehensive rehabilitation therapy for 18 months, the patient showed improvement in muscle power and functional level with improvement in electrophysiologic parameters.