Somatosensory-evoked potentials and MRI in tuberculous spondylodiscitis.
Early diagnosis of spondylodiscitis is a condition of efficient conservative treatment. Somatosensory-evoked potentials with clinical examination results are used in assessing the diagnosis, as well as in monitoring the course of disease and healing. MRI clearly shows the inflammatory process, healing and scars. We report a 46-year-old woman suffering from non-specific interscapular pains. The evoked somatosensory potentials of the tibial nerveshow potential conductivity being slowed down through the thoracic spine, which is clearly evident from the prolonged latency and the decreased amplitude of the evoked response. The performed thoracic spine MRI shows spondylodiscitis at the Thl0-11 level. The subject is a nurse administering BCG therapy at a urology clinic, due to the fact of which this was deemed to have been a case of tuberculous spondylodiscitis. Due to the possibility of scattering the causative agent by needle, the biopsy was given up and antituberculous therapy was administered ex juvantibus. The disease was followed up by clinical examinations, somatosensory-evoked potentials and MRI up to fully successful and final recovery from spondylodiscitis. The above examinations are of great help in diagnosing the tuberculous spondylodiscitis and monitoring the recovery (Fig. 6, Ref. 16).
Department of Neurology, Clinical Hospital Split, Split, Croatia. marina.titlic@inet.hr
M
M
Titlic
V
V
Isgum
A
A
Buca
K
K
Kolic
A
A
Tonkic
I
I
Jukic
I
I
Milas
D001500:BCG Vaccine / Q000627:therapeutic use; D015299:Discitis / Q000175:diagnosis* / Q000382:microbiology; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009729:Nursing; D009784:Occupational Diseases / Q000175:diagnosis; D013904:Thoracic Vertebrae; D014399:Tuberculosis, Spinal / Q000175:diagnosis* / Q000188:drug therapy
D001500:BCG Vaccine