결핵성 뇌막염환자에서 발생한 눈벌림 마비

Divergence Paralysis in Tuberculous Meningitis

Purpose: We report a case of divergence paralysis associated with tuberculous meningitis. Case summary: A 28 year old man was diagnosed with tuberculous meningitis based on clinical manifestation, cerebrospinal fluid analysis and brain magnetic resonance imaging and was administered anti-tuberculous medication. Four days later, diplopia at distance occurred and the patient was referred to ophthalmologic clinic. Eye motility examination revealed comitant esotropia of 10 prism diopters (PD) at distance and esophoria of 2 PD at near. There was no limitation of eye movement. He was diagnosed with divergence paralysis. 1 week later, esotropia and diplopia are completely resolved. Conclusions: Divergence paralysis associated to tuberculous meningitis is very rare and has not been reported previously. The authors believe this is a case of divergence paralysis associated to tuberculous meningitis and report it as a rare case.