Clinical Presentation and Diagnosis of Tuberculosis
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Tuberculous meningitis is the most lethal form of tuberculosis. Even with modern chemotherapy, the outcome is often poor with severe neurologic sequelae because the diagnosis is often delayed. Only patients without neurologic symptoms at diagnosis can be expected to have an uneventful outcome. Among a multitude of neurologic symptoms, cranial nerve involvement is not uncommon. In this patient the sixth cranial nerve, Nervus abduces, was affected: because it is a basal meningitis and the sixth cranial nerve follows the longest path among all cranial nerves along the basis of the brain, this finding is not uncommon. In this patient, the resulting squinting gradually disappeared with chemotherapy.