BMJ Case Reports 2012; doi:10.1136/bcr-2012-006262
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Paradoxical extensive thoracolumbosacral arachnoiditis in a treated patient of tuberculous meningitis

  1. Arvind Gupta
  1. Department of Neurology, Chhatrapati Shahuji Maharaj Medical University, Lucknow, Uttar Pradesh, India
  1. Correspondence to Dr Hardeep Singh Malhotra, drhsmalhotra{at}


A 32-year-old lady presented with a 7-month history of gradually progressive, areflexic, asymmetric-onset, sensorimotor paraparesis accompanied by bowel and bladder involvement. She had previously been diagnosed with tuberculous meningitis, for which she completed a course of antituberculosis treatment (2 months—isoniazid, rifampicin, pyrazinamide, streptomycin; 7 months—isoniazid, rifampicin) with supplemental dexamethasone, for 6 weeks, 11 months prior to presentation. A review of the old records revealed culture positivity, without resistance, for Mycobacterium tuberculosis and significantly elevated protein level (736 mg/dl) in the cerebrospinal fluid; serology was found to be non-reactive for HIV-I and II. …

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