Thalamic Tuberculoma Presenting as Isolated Gait Disturbance Without Systemic or Meningeal Symptoms in a 2-Year-Old Child: A Case Report.
Khadija Yasmin, Muhammad Abdullah, Sana Shaik et al.
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Case in brief
A 2-year-old boy presented with isolated gait disturbance and decreased power on the left side, without systemic or meningeal symptoms. MRI revealed a ring-enhancing lesion in the right thalamus, and magnetic resonance spectroscopy indicated an infectious granulomatous etiology. A presumptive diagnosis of thalamic tuberculoma was made, and the child was treated with anti-tuberculous therapy, leading to improvement.
What made this case unusual
The case highlights an atypical presentation of thalamic tuberculoma, manifesting solely as gait disturbance without systemic symptoms, which is rare and can lead to diagnostic delays.
Diagnostic / clinical pearl
Clinicians should consider intracranial tuberculoma in children presenting with isolated neurological deficits, even in the absence of systemic tuberculosis symptoms.
Why it matters
Recognizing atypical presentations of intracranial tuberculoma can facilitate early diagnosis and treatment, improving outcomes in pediatric patients.