Received: January 05, 2011
Accepted: November 30, 2011
Lalla RS, Singh RK, Rawat KJ, Chewoolkar VC. Central nervous system tuberculomata presenting as internuclear ophthalmoplegia. Internet J Med Update. 2012 Jan;7(1):59-61.


Rakesh S Lalla* MD, Raminder K Singh** MD, Kavita J Rawat MD and Vaibhav C Chewoolkar MD

*Assistant Professor, **Professor and Head, Associate Professor, Assistant Professor, Department of Medicine, Seth GS Medical College & KEM Hospital, Mumbai, Maharashtra, India

(Corresponding Author: Dr Rakesh S Lal, Department of Medicine, Seth GS Medical College & KEM Hospital, Mumbai 400012, Maharashtra, India; Tele-fax: 022-24172267; Email:


Central nervous system (CNS) tuberculoma can have variable presentation depending upon the site and number of tuberculomata. We are reporting a rare case of a 15 years old girl who presented to our hospital with binocular diplopia on right gaze. Clinical examination revealed left sided internuclear ophthalmoplegia and dysdiadochokinesia and ataxia on left side. Magnetic Resonance Imaging (MRI) of brain revealed multiple tuberculomata in both cerebral hemispheres, cerebellum, left half of medulla and pons. This case highlights the need for a high degree of suspicion for CNS tuberculosis in patients presenting with internuclear ophthalmoplegia.

KEY WORDS: Brainstem; Tuberculoma; Internuclear; Ophthalmoplegia; Syndrome

Images from this publication

Demonstrating failure of left eye to adduct and nystagmus occurring in the right eye while looking right T2W images with FLAIR showing perilesional oedema along tuberculomata in left half of dorsal pons and left cerebellar hemisphere
Post contrast ring like enhancement seen with multiple lesions seen in bilateral cerebral and cerebellar hemisphere and pons and medulla