Intrathecal Hyaluronidase In Tubercular Arachnoiditis The Unexplored Adjuvant

Intrathecal hyaluronidase for short duration as an adjuvant for treatment of tubercular arachnoiditis was tried in the past, and although the initial results were promising, surprisingly, no further confirmatory studies were undertaken and have not come into routine clinical use. We did a retrospective chart review of 25 patients who had tubercular meningitis with spinal or opticochiasmatic arachnoiditis who were given weekly intrathecal hyaluronidase for 10 weeks, in addition to antitubercular drugs and steroids. Of the 19 patients with spinal tubercular arachnoiditis, 10 were independent by the time of completion of therapy. All patients with opticochiasmatic arachnoiditis showed some improvement in vision. This promising retrospective study highlights the utility of hyaluronidase in tubercular meningitis with arachnoiditis and need of prospective randomized control trial.