TY - JOUR T1 - Bilateral trigeminal motor nucleus syndrome JF - Practical Neurology JO - Pract Neurol SP - 431 LP - 432 DO - 10.1136/practneurol-2021-002953 VL - 21 IS - 5 AU - Chulika Makawita AU - Tharuka Herath AU - Medini Boteju AU - Nalin Karunasena AU - Sivanesan Pratheepa AU - Sunethra Senanayake Y1 - 2021/10/01 UR - http://pn.bmj.com/content/21/5/431.abstract N2 - A 48-year-old man was brought to our unit with deteriorating consciousness but no available history. His Glasgow Coma Scale score was 11/15 (E3, V4, M4). A limited neurological examination identified neck stiffness with normal upper and lower limbs except for extensor plantar responses. Cranial nerve examination was also limited, but with no obvious ophthalmoplegia, facial weakness, wasting of muscles of mastication or jaw drop. Following intubation, he was found to have persistently elevated inflammatory markers but negative blood and urine cultures. MR scan of brain with contrast showed multiple ring-enhancing lesions and meningeal enhancement without hydrocephalus (figure 1). Cerebrospinal fluid (CSF) analysis showed a raised protein, with lymphocytosis and low glucose. Nucleic acid amplification test of CSF for tuberculosis was positive.Figure 1 MR scan of brain showing multiple … ER -