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J Pediatr Infect Dis 2010; 05(01): 087-090
DOI: 10.3233/JPI-2010-0209
Georg Thieme Verlag KG Stuttgart – New York

Tuberculous meningitis presenting as hemiplegia alternans in two children

Regan Solomons
a   Department of Pediatrics and Child Health, Tygerberg Children’s Hospital Faculty of Health Sciences, University of Stellenbosch, Western Cape, South Africa
,
Ronald van Toorn
a   Department of Pediatrics and Child Health, Tygerberg Children’s Hospital Faculty of Health Sciences, University of Stellenbosch, Western Cape, South Africa
,
Johan F. Schoeman
a   Department of Pediatrics and Child Health, Tygerberg Children’s Hospital Faculty of Health Sciences, University of Stellenbosch, Western Cape, South Africa
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Publication History

23 December 2008

14 May 2009

Publication Date:
28 July 2015 (online)

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Abstract

We describe the crossed syndromes of Millard-Gubler (facial palsy and contralateral hemiparesis) and Weber (oculomotor palsy and contralateral hemiparesis) in two children with tuberculous meningitis. The magnetic resonance imaging delineated the pathology in both cases and response to therapy proved favorable. In both children the cranial neuropathies resolved whilst the hemiparesis persisted. The cases highlight the importance of considering neurotuberculosis as a cause of hemiplegia alternans in endemic tuberculosis areas.

Keywords

Hemiplegia alternans - millard-Gubler syndrome - weber’s syndrome - tuberculoma - tuberculous meningitis