Antitubercular treatment-induced chronic progressive sensory-motor polyneuropathy with optic neuropathy

Abstract

Polyneuropathy is a major complication in tuberculosis (TB) patients associated with various causes, including comorbid conditions and antitubercular medications, particularly involving drugs such as isoniazid (INH) and ethambutol. INH interferes with pyridoxine synthesis, leading to sensory peripheral neuropathy, and presents with symptoms such as tingling, burning, numbness, and difficulty in walking. Ethambutol, on the other hand, is associated with optic neuropathy, presenting as bilateral and symmetrical visual field abnormalities. We report a case of a 39-year-old male with TB undergoing antitubercular treatment for 4 months, experiencing weakness in all four limbs and blurred vision. The patient developed chronic progressive sensory-motor polyneuropathy with optic neuropathy. Prevention strategies, routine screening, and prompt management are crucial in mitigating the impact of this condition. The article emphasizes the importance of early identification, withdrawal of offending agents, and management strategies, such as vitamin supplementation and physical therapy, to prevent permanent disability.