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• Vol.55 No.11
• CLINICA NEUROL, 55: 816−822, 2015
• Vol.55 No.11 contents

Case Report

A case of tuberculous myeloradiculitis with abdominal lymphadenitis presenting with symptoms of radiculomyelopathy

Yutaka Suto, M.D.¹⁾³⁾, Satoru Ito, M.D.¹⁾, Takashi Nomura, M.D.¹⁾, Yasuhiro Watanabe, M.D.¹⁾, Shinichiro Kitao, M.D.²⁾, Hiroyuki Nakayasu, M.D.³⁾ and Kenji Nakashima, M.D.¹⁾

¹⁾Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University
²⁾Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University
³⁾Department of Neurology, Tottori Prefectural Central Hospital

A 30-year old man was admitted with right hip pain and gait disturbances. Neurological findings revealed muscular weakness in the lower limbs, hyporeflexia, dysesthesia in the sacral region, and bowel and bladder disturbances. Cerebrospinal fluid (CSF) examination indicated a white blood cell count of 371/μl (lymphocyte:polymorphonuclear leukocyte = 97:3), protein levels of 463 mg/dl and sugar of 20 mg/dl. Although CSF culture was negative, tuberculous infection was presumed. Magnetic resonance imaging revealed areas of enhancement in the intramedullary region surrounding the spinal cord and cauda equina. Enhanced computed tomography (CT) of the abdomen revealed lymph node swelling around the head of the pancreas. Biopsy of the lymph node swelling was culture-positive for Mycobacterium tuberculosis. Hence, assuming a diagnosis of tuberculous lymphadenitis of the abdomen, antitubercular drugs were started. Since antitubercular therapy had beneficial effects on the neurological symptoms and CSF findings, we diagnosed the patient with tuberculous myeloradiculitis. Systematic examinations including lymph node biopsy and cultures were useful for the diagnosis of tuberculous myeloradiculitis.
Full Text of this Article in Japanese PDF (878K)

(CLINICA NEUROL, 55: 816−822, 2015)
key words: radiculomyelopathy, myeloradiculitis, lymphadenitis, tuberculous meningitis

(Received: 6-Feb-15)