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  • Title: Tuberculous meningitis-related optic neuritis: recovery of vision with thalidomide in 4 consecutive cases.
    Author: Schoeman JF, Andronikou S, Stefan DC, Freeman N, van Toorn R.
    Journal: J Child Neurol; 2010 Jul; 25(7):822-8. PubMed ID: 20519667.
    Abstract:
    Blindness is an uncommon but devastating complication of tuberculosis meningitis. The main causes are chronically raised intracranial pressure (hydrocephalus and/or tuberculomas) or direct involvement of the optic chiasm or optic nerves by the basal arachnoiditis (inflammation and/or compression). Antituberculosis therapy combined with corticosteroids and control of intracranial pressure constitutes the mainstay of therapy for tuberculous meningitis. Despite these treatment measures, some patients develop blindness, mainly as a result of progressive optochiasmatic arachnoiditis. This led us to explore the role of adjuvant thalidomide therapy, and we describe the dramatic recovery of vision in 4 consecutive cases. Clinical recovery was accompanied by marked radiological improvement on magnetic resonance imaging (MRI) of the brain.
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