Cranial nerve involvement: its role in intracranial tuberculosis


  • Baiakmenlang Synmon Department of Neurology, NEIGRIHMS, Shillong, Meghalaya, India
  • Ashok Kayal Department of Neurology, Apollo Hospital, Guwahati, Assam, India



Cranial nerve involvement, Tubercular meningitis


Background: Tubercular meningitis is the most severe form of extra pulmonary involvement. Lack of specific and sensitive test calls for a multi-displinary and combined approach to make the diagnosis at the earliest. Various factors guide us to the etiology of meningoencephalitis but cranial nerve involvement has the highest predictive value.

Methods: A prospective study from August 2013 to September 2015 carried in GMCH, Guwahati where 93 patients of intracranial tuberculosis was included.

Results: This present   study comprised of 36 females (38.7%) and 57 males (61.3%) with a mean age of   32.3±17.05 and a range of 2-72 years. The typical clinicalfeatures of meningitis was found in 78.6%. Focal neurological deficit and cranial nerve involvement was seen in 40 (43%) and 58 (62.4%) respectively. Among the cranial nerves (CN), the most commonly involved is the 2nd CN seen in 33 (35.5%), followed by 6th (16.1%), 7th (11.8%), 3rd (7.5%), 8th (3.2%), 9th  and 10th, (2.2%) 4th (1.1%) and 5th (1.1%). Six patients developed visual loss and two patients hearing loss as sequelae. The presence of cranial nerve involvement and focal neurological deficit was shown to be associated with a poor prognosis (p value=0.04**, significant; Fisher’s exact test).

Conclusions: Bedside clinical examination of patients of meningoencephalitis to detect cranial nerve involvement will definitely help us with the diagnosis and prognosis of tubercular meningitis.

Author Biography

Baiakmenlang Synmon, Department of Neurology, NEIGRIHMS, Shillong, Meghalaya, India



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How to Cite

Synmon, B., & Kayal, A. (2020). Cranial nerve involvement: its role in intracranial tuberculosis. International Journal of Research in Medical Sciences, 9(1), 196–199.



Original Research Articles