Neurological complications of miliary tuberculosis
| Autor: | Rohitash Sharma, Ravindra Kumar Garg, Rakesh Shukla, Alok Mohan Kar, Rajesh Verma, Maneesh Kumar Singh, Ram Avadh Singh Kushwaha, Atul Agarwal |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Miliary tuberculosis Adolescent Antitubercular Agents Neurological examination Transverse myelitis Tuberculous meningitis Central nervous system disease Myelopathy Young Adult HIV Seropositivity medicine Humans Tuberculoma Neurologic Examination medicine.diagnostic_test business.industry Tuberculosis Miliary Brain HIV General Medicine Middle Aged medicine.disease Magnetic Resonance Imaging Surgery Treatment Outcome Spinal Cord Tuberculosis Meningeal Female Neurology (clinical) business Meningitis Follow-Up Studies |
| Zdroj: | Clinical neurology and neurosurgery. 112(3) |
| ISSN: | 1872-6968 |
| Popis: | Introduction The symptomatic central nervous system involvement is often seen in patients with miliary tuberculosis. Materials and methods In this study, we evaluated 60 consecutive miliary tuberculosis patients, who presented with some neurological manifestations. Evaluation included neurological examination, a battery of blood tests, HIV serology, sputum examination, cerebrospinal fluid (CSF) examination along with imaging of the brain and spinal cord. The patients were followed up after completion of 6 months of antituberculous treatment. Results Patients ranged between 14 and 53 years in age. Three patients tested HIV positive. Forty-eight (80%) patients had tuberculous meningitis. In 12 (20%) patients, the CSF examination was normal. In 27 patients with tuberculous meningitis, neuroimaging revealed intracerebral tuberculoma. Fourteen patients showed multiple tuberculomas, while 7 had a solitary tuberculoma. In six patients, the tuberculomas were small and numerous. In two patients, neuroimaging revealed a spinal tuberculoma. For three patients with tuberculous brain masses, the CSF was normal. Nine (15%) patients presented with myelopathy. Three patients exhibited Pott's paraplegia. Three patients had transverse myelitis (with normal neuroimaging). In three patients, the spinal MRI revealed an intramedullary tuberculoma. On follow-up, 15 (25%) patients expired. Thirty-one (52%) patients showed significant improvement. Eight patients (13%) showed nil or partial recovery. Six of the patients with no improvement developed vision loss. Six (10%) patients were lost to follow up. Conclusion A variety of neurological complications were noted in military tuberculosis patients, tuberculous meningitis and cerebral tuberculomas being the most frequent complications. However, a majority of patients improved following antituberculous treatment. |
| Databáze: | OpenAIRE |
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