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Central nervous system tuberculomata presenting as internuclear ophthalmoplegia

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Author(s): Rakesh S Lalla | Raminder K Singh | Kavita J Rawat | Vaibhav C Chewoolkar

Journal: Internet Journal of Medical Update
ISSN 1694-0423

Volume: 7;
Issue: 1;
Start page: 59;
Date: 2012;
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Keywords: Brainstem | Tuberculoma | Internuclear | Ophthalmoplegia | Syndrome

ABSTRACT
Central nervous system (CNS) tuberculoma can have variable presentation depending upon the site and number of tuberculomata. We are reporting a rare case of a 15 years old girl who presented to our hospital with binocular diplopia on right gaze. Clinical examination revealed left sided internuclear ophthalmoplegia and dysdiadochokinesia and ataxia on left side. Magnetic Resonance Imaging (MRI) of brain revealed multiple tuberculomata in both cerebral hemispheres, cerebellum, left half of medulla and pons. This case highlights the need for a high degree of suspicion for CNS tuberculosis in patients presenting with internuclear ophthalmoplegia.

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