A Case of Devic’s Neuromyelitis Optica with Pulmonary Tuberculosis

J Korean Neurol Assoc > Volume 18(1); 2000 > Article

Journal of the Korean Neurological Association 2000;18(1): 85-88.

폐결핵이후 발생한 시속신경척수염 1예

정상준, 박기형 ·김희태 ·김명호

한양대학교 의과대학 신경과학교실

A Case of Devic’s Neuromyelitis Optica with Pulmonary Tuberculosis

Sang-Joon Jung, M.D., Kee-Hyung Park, M.D., Hee-Tae Kim, M.D., Myung-Ho Kim, M.D.

Department of Neurology, College of Medicine, Hanyang University

Abstract

Neuromyelitis optica (Devic’s syndrome) is characterized by acute bilateral visual loss (optic neuritis), acute trans-verse myelitis, near simultaneous development of these optic and spinal symptoms, no other symptoms and involve-ment of the central nervous system. Sporadic reports of patients with neuromyelitis optica in association with tubercu-losis confined to the lungs have appeared over the last years. A 67-year-old man presented with visual disturbance and sudden onset of lower limb weakness. On neurological examination, bilateral visual loss, flaccid paraparesis, hypesthe-sia below T2 dermatome, and extensor plantar responses were noted. Chest X-ray revealed bilateral nodular densities in the upper lung fields and a fluorochrome stain for tuberculosis was positive. Magnetic resonance imaging showed spinal cord swelling and high signal intensity (T2WI) in thoracic spinal cord. We report a case of neuromyelitis optica with pulmonary tuberculosis. It is suggested that this condition might caused by an immune reaction to tuberculosis rather than the use of antituberculosis medication. J Korean Neurol Assoc 18(1):85~88, 20000 Key Words : Neuromyelitis optica, Pulmonary tuberculosis, Immune reaction