Pulse corticosteroids for the management of extensive CNS tuberculosis presenting with acute-onset quadriparesis.

Abstract

Myelopathy in central nervous system tuberculosis is notorious for poor outcomes, determined by the severity of inflammation and cord level involved. Acute-onset quadriplegia or paraplegia in these cases represents a neuro-emergency. We report a young female with disseminated tuberculosis who presented with acute onset flaccid quadriparesis with loss of bladder and bowel function. Imaging helped identify the extensive involvement of the neuraxis. We propose that, in addition to anti-tubercular therapy, high-dose corticosteroids such as pulse methylprednisolone may result in a meaningful improvement and show greater rapidity of response in cases of severe central nervous system inflammation such as arachnoiditis or myelopathy.

• Authors: Umang Arora, Prerna Garg, Shrawan Kumar Raut, Deepti Vibha, Upendra Baitha, Atin Kumar, Pankaj Jorwal, Manish Soneja, Ashutosh Biswas
• Journal: Drug discoveries & therapeutics (Drug Discov Ther) Vol. 16 Issue 2 Pg. 102-104 (May 17 2022) ISSN: 1881-784X [Electronic] Japan
• PMID: 35321986 (Publication Type: Journal Article)

Chemical References

• Adrenal Cortex Hormones

Topics

• Adrenal Cortex Hormones
• Female
• Humans
• Inflammation
• Quadriplegia (drug therapy, etiology)
• Spinal Cord Diseases
• Tuberculosis, Central Nervous System (complications, diagnostic imaging, drug therapy)