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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diagnosed With Tuberculosis Of Brain. Critical Condition. Why Can't He Open His Eyes?

my wife s sisters son aged 8 years has been diagnosed with tuberculosis of the brain and admitted to gandhi hospital, as of now his position is critical. Tb has affected his head and spinal cord . he is sometimes in a stupor, sometimes cries hard not eblae to open his eyes , ina curled up position with lot of pain. pls advise.
Fri, 21 Sep 2012
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Ophthalmologist 's  Response
Hi Rajmc,
Welcome to HCM.
From the above mentioned symptoms, I think your child is suffering from ptosis( drooping of eye lid) due to third cranial nerve paralysis a sequelae of tubercular meningoencephalitis. All he needs right now is appropriate anti tubercular medications, which by now I think your emergency management doctors would have already started on, and an neuro ophthal opinion to keep an eye of his optic nerve status too( as multiple cranial nerve palsy is commonly noted).

Once he is out of the critical stage, the ptosis should recover if it is due to TB infection.The brain with its multiple complex nervous system and spinal cord are quite complicated, as the recovery depends on each individual and the extent of his Tubercular spread. However, neurologic sequelae may remain despite proper therapy in cases of severe tuberculous meningitis.

So let's hope for the best for him and wish him a speedy recovery.
Take care.
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Diagnosed With Tuberculosis Of Brain. Critical Condition. Why Can't He Open His Eyes?

Hi Rajmc, Welcome to HCM. From the above mentioned symptoms, I think your child is suffering from ptosis( drooping of eye lid) due to third cranial nerve paralysis a sequelae of tubercular meningoencephalitis. All he needs right now is appropriate anti tubercular medications, which by now I think your emergency management doctors would have already started on, and an neuro ophthal opinion to keep an eye of his optic nerve status too( as multiple cranial nerve palsy is commonly noted). Once he is out of the critical stage, the ptosis should recover if it is due to TB infection.The brain with its multiple complex nervous system and spinal cord are quite complicated, as the recovery depends on each individual and the extent of his Tubercular spread. However, neurologic sequelae may remain despite proper therapy in cases of severe tuberculous meningitis. So let s hope for the best for him and wish him a speedy recovery. Take care.