International medical case reports journal
Thalamic Tuberculoma Presenting as Isolated Gait Disturbance Without Systemic or Meningeal Symptoms in a 2-Year-Old Child: A Case Report
By Yasmin K, Abdullah M, Shaik S and 5 others.
Abstract
Introduction
Intracranial tuberculoma is an important manifestation of pediatric central nervous system tuberculosis, especially in endemic regions. While seizures and signs of raised intracranial pressure are common presenting features, isolated focal neurological deficits without systemic or meningeal symptoms are rare, resulting in diagnostic delay. We report an unusual case of thalamic tuberculoma presenting primarily with gait disturbance in a young child.
Case presentation
A 2-year-old boy from Karachi, Pakistan, presented with inability to walk independently at 20 months age. On neurological examination, he had decreased power involving left side of body. MRI of the brain showed a ring-enhancing lesion in the right thalamus extending into the midbrain with surrounding vasogenic edema. Magnetic resonance spectroscopy (MRS) showed a lipid/lactate peak, which supported an infectious granulomatous etiology; a presumptive diagnosis of tuberculoma was made based on imaging findings and household TB exposure.