Question of the Week

Question :

Posted On : 31 May 2005

Can a 5yr old male have left conjugate gaze palsy involving left MLF ,with simultaneous UMN type of facial nerve palsy as a complication of TB Meningitis?If SO ,kindly explain the mechanism.

Expert Answer :

No expert answer available.

Answer Discussion :

Rizwan

Yes, because there is release of bacilli in the subarachnoid space. The resulting gelatinous exu7date may infiltrate the corticomeningeal blood vessels producing obstruction, inflammation and infarction of the cerebral cortex. The brain stem is often the site of maximum involvement.

19 years ago

Jaime Bohlman

CN VI and CN VII are located in midbrain in close proximity to eachother.

19 years ago

pediatriconcall

Left conjugate palsy may be due to raised intracranial tension leading to lateral rectus palsy. Also the UMN facial nerve palsy could be due to vasculitis of the middle cerebral artery or a tuberculoma.
If both the abducens nerve and LMN facial were present, one would rule out brain stem vasculitis as the cause.

19 years ago

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