Abstract :
Tubercular infection of central nervous system (CNS) is still a major cause of morbidity and mortality in low to middle income countries. Spinal intramedullary tuberculosis (SIMT) is rarest form of CNS TB and manifests in the form of myelo radiculitis, intramedullary tuberculomas, anterior spinal artery thrombosis and transverse myelitis which is rarely fulfils criteria of a longitudinally extensive transverse myelitis (LETM). We present a rare case of acute transverse myelopathy in a 35 years old male patients, which unveiled previously undiagnosed pulmonary tuberculosis. The patient responded well to anti tubercular therapy and corticosteroids. This case will emphasize upon the fact that in endemic zones SIMT, especially tubercular LETM, should always be kept in the differential diagnoses of acute transverse myelopathy because delay in diagnosis will lead to long term morbidity and debility. Hence, the primary care physicians who get the cases earliest should cultivate a high index of suspicion to diagnose a potentially lifetime debilitating yet absolutely treatable clinical condition i.e. tubercular LETM.
Keyword :
Tuberculosis, Longitudinally extensive transverse myelitis, Corticosteroids