KMID : 0361420140380030405
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Journal of Korean Academy of Rehabilitation Medicine 2014 Volume.38 No. 3 p.405 ~ p.409
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Paralysis Developing as a Paradoxical Response During the Treatment for Tuberculous Spondylitis: A Case Report
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Park Jae-Hyeon
Kim Yeo-Hyung Kwon Chan-Hyuk Shin Hyung-Ik
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Abstract
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It can be difficult for clinicians to distinguish a paradoxical response to antituberculous therapy, worsening of an existing lesion despite adequate treatment, treatment failure, and drug resistance. We report a case of a 69-year-old woman who experienced bilateral lower extremity paralysis secondary to a paradoxical response. She had been suffering for 1 month from low back pain, due to tuberculous spondylitis. Her low back pain improved after antituberculous therapy. The low back pain, however, reappeared 2 months after treatment, accompanied by newly developed lower extremity weakness. Imaging studies showed an increased extent of her previous lesions. Consequently, the patient underwent a vertebral corpectomy with interbody fusion of the thoracolumbar spine. Histopathological examination showed chronic inflamed granulation tissue with no microorganisms. Although the antituberculous medication was not changed, the patient¡¯s symptoms and signs, including the paralysis, resolved after surgery.
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KEYWORD
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Paradoxical response, Spinal tuberculosis, Paralysis
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