Tuberculous Meningitis-Related Optic Neuritis: Recovery of Vision With Thalidomide in 4 Consecutive Cases

被引：41

作者：

Schoeman, Johan F. ^{[1
]}

Andronikou, Savvas ^{[2
]}

Stefan, D. Christina ^{[1
]}

Freeman, Nicola ^{[3
]}

van Toorn, Ronald ^{[1
]}

机构：

[1] Univ Stellenbosch, Tygerberg Childrens Hosp, Dept Pediat & Child Hlth, Fac Hlth Sci, Western Cape, South Africa

[2] Univ Stellenbosch, Tygerberg Hosp, Dept Radiol, Fac Hlth Sci, Western Cape, South Africa

[3] Univ Stellenbosch, Tygerberg Hosp, Dept Ophthalmol, Fac Hlth Sci, Western Cape, South Africa

来源：

JOURNAL OF CHILD NEUROLOGY | 2010年 / 25卷 / 07期

关键词：

tuberculosis meningitis; optic arachnoiditis; blindness; thalidomide; recovery of vision; OPTOCHIASMATIC ARACHNOIDITIS; VISUAL-LOSS;

D O I：

10.1177/0883073809350507

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Blindness is an uncommon but devastating complication of tuberculosis meningitis. The main causes are chronically raised intracranial pressure (hydrocephalus and/or tuberculomas) or direct involvement of the optic chiasm or optic nerves by the basal arachnoiditis (inflammation and/or compression). Antituberculosis therapy combined with corticosteroids and control of intracranial pressure constitutes the mainstay of therapy for tuberculous meningitis. Despite these treatment measures, some patients develop blindness, mainly as a result of progressive optochiasmatic arachnoiditis. This led us to explore the role of adjuvant thalidomide therapy, and we describe the dramatic recovery of vision in 4 consecutive cases. Clinical recovery was accompanied by marked radiological improvement on magnetic resonance imaging (MRI) of the brain.

引用

页码：822 / 828

页数：7

共 25 条

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