Neurobrucellosis: A Great Mimicker in Disguise
Kavya Lahari Akshinthala1, Rindha V Rao1, Divya Teja Garapati1, Sireesha Yareeda1, Surya Prabha Turaga1, Vikram Sharma2, Reshma Sultana Shaik1
1Department of Neurology, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India.
2Department of Radiology, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India.
*Corresponding Author: Reshma Sultana Shaik, Assistant Professor of Neurology, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India, 500082
DOI: https://doi.org/10.58624/SVOANE.2026.07.007
Received: February 02, 2026
Published: February 18, 2026
Citation: Akshinthala KL, Rao RV, Garapati DT, Yareeda S, Turaga SP, Sharma V, Shaik RS. Neurobrucellosis: A Great Mimicker in Disguise. SVOA Neurology 2026, 7:1, 33-37. doi. 10.58624/SVOANE.2026.07.007
Abstract
Background: Neurobrucellosis is a rare clinical complication of brucellosis that can manifest in isolation without systemic features. Subacute to chronic onset and progression of sensory neural hearing loss (SNHL) secondary to isolated affection of the eighth nerve can be a diagnostic clue.
Methods: Descriptive study of a case of a 28-year-old gentleman with a progressive painless bilateral sensory neural hearing loss (SNHL) of 4 months duration and spastic dysarthria of 2 months duration. His neurological examination revealed bilateral SNHL and a spastic ataxic dysarthria with pan cerebellar dysfunction. A clinical diagnosis of intraxial brainstem syndrome was considered. Workup with imaging, serology and cerebrospinal fluid analysis was advised.
Results: Imaging showed hyperintensities in the subcortical and juxtacortical areas of the left frontal and bilateral temporal lobes. Serum IgG Brucella Antibody by enzyme-linked immunosorbent assay(ELISA) had a titre of 92 RU/ml(Normal range <22 RU/ml). Cerebrospinal Fluid(CSF) analysis was performed on three occasions, consistently showing lymphocytic pleocytosis, elevated protein, and low glucose levels. Isolated affection of the eighth cranial nerve is a known clinical phenotype in Neurobrucellosis.
Conclusion: Neurobrucellosis is an underrecognized neuroinfection in India, despite its endemic status for this infection. Our case exhibits several distinctive features. The absence of fever in our case doesn’t exclude Neurobrucellosis.. The presence of demyelinating features on imaging, CSF oligoclonal bands (OCB), and CSF suggestive of neuroinfection hints at an interplay between infection and immunity.
Keywords: Neurobrucellosis, Sensory Neural Hearing Loss (Snhl), Igg Brucella Antibody, Enzyme-Linked Immunosorbent Assay (Elisa), Isolated Cranial Nerve Eight
