Abstract

Seizures may frequently occur during tuberculous meningitis. We describe a patient with an apparent generalised tonic-clonic seizure, initially not associated with any magnetic resonance imaging (MRI) abnormality, which was the presenting symptom of tuberculous meningitis. Follow-up MRI, performed after gadolinium administration, showed signs of meningeal involvement. Seizures may be the presenting symptoms of tuberculous meningitis even in the absence of evident intracerebral lesions on MRI. Therefore, contrast-enhanced brain MRI should be performed in the diagnostic workup for each first seizure, especially in patients with a clinical suspicion of CNS infectious disease. The term "heraldic seizure", indicating a subset of acute symptomatic seizures presenting at the onset of a brain/systemic injury or preceding the full clinical manifestation of a cerebral insult, may be helpful to classify these seizures retrospectively, based initially on unknown aetiology.

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Publisher Full Text

Authors

Brigo F, Ausserer H, Zuccoli G, Tezzon F, Nardone R

Institution

Department of Neurological, Neuropsychological, Morphological and Movement Sciences. Section of Clinical Neurology. University of Verona, Italy, Department of Neurology, Franz Tappeiner Hospital, Merano, Italy.

Source

Epileptic disorders : international epilepsy journal with videotape 14:3 2012 Sep pg 329-33

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22940820