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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Tuberculous Meningitis

a young patient diagnosed TB meningitis and on ATT, referred to ophthal op for c/o diplopia.. on examination her vision is 6/9 in both eyes, restriction of abduction, dextroelevation ,dexrodepression mimicking lateral rectus palsy in right eye other movements are normal. diplopia is present in all gazes.. no ocular pain. MRI shows lenticular infarcts and lesions in cerebellum. no lesions related to orbit.. what could be the reason?
Mon, 26 Dec 2016
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General & Family Physician,  's  Response
Hi,
Thanks for your question. I do understand your pain and discomfort. I have seen many cases with similar complaints. Please find my advice below-:
1)Start treatment for tuberculous meningitis INH+RIF+PZA
2)Check ICP and add steroid
3)management of Lentricular infarct should be with-Activan,Cerebyx,Cardene & Mannitol
4)Control BP and ICP in ICU which is the key factor of patient management & recovery.

I hope I was able to address your query. If you have any further questions, please do not hesitate to write to me.
Wishing you all the best.
Thanks,
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Suggest Treatment For Tuberculous Meningitis

Hi, Thanks for your question. I do understand your pain and discomfort. I have seen many cases with similar complaints. Please find my advice below-: 1)Start treatment for tuberculous meningitis INH+RIF+PZA 2)Check ICP and add steroid 3)management of Lentricular infarct should be with-Activan,Cerebyx,Cardene & Mannitol 4)Control BP and ICP in ICU which is the key factor of patient management & recovery. I hope I was able to address your query. If you have any further questions, please do not hesitate to write to me. Wishing you all the best. Thanks,