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Free Content Tuberculous radiculomyelitis: review and presentation of five patients

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Abstract:

BACKGROUND: The southeast region of Iran is an endemic area for tuberculosis. Tuberculous radiculomyelitis (TBRM) was considered a rare form of parenchymal neurotuberculosis.

OBJECTIVE: To analyze the clinical, laboratory and electrophysiological data of patients with TBRM. We report five patients and review the literature.

METHOD: We searched Medline since 1966 and reviewed all cases of TBRM, excluding those with Pott's disease. We then evaluated the clinical and electrophysiological data of our patients.

RESULTS: Five patients (two men), with a mean age of 25 years, were assessed. The mean duration of symptoms before diagnosis was 4.5 weeks. Three patients had clinical manifestation of tuberculous meningitis (TBM). Diagnosis was based on sputum smear and culture, cerebrospinal fluid (CSF) culture and polymerase chain reaction (PCR) gene amplification of Mycobacterium tuberculosis. Paraparesis or paraplegia, sphincter incontinence and Babinski sign were the main clinical features. CSF analysis was compatible with chronic meningitis. Electromyography showed radiculopathy in all patients and peripheral nerve disease secondary to axonal damage in only three, while myelography showed adhesive arachnoiditis in three.

CONCLUSION: Despite the rarity of TBRM, clinical features were well described. To prevent neurological sequelae, early diagnosis and treatment is mandatory. Electrophysiological study may predict the prognosis.

Keywords: Iran; arachnoiditis; electromyography; radiculomyelitis; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Neurology Department, Zahedan University of Medical Sciences, Zahedan, Iran 2: Department of Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran

Publication date: 2003-12-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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