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Neurological complications of miliary tuberculosis.
Clin Neurol Neurosurg. 2010 Apr; 112(3):188-92.CN

Abstract

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.

Authors+Show Affiliations

Department of Neurology, Chhatrapati Shahuji Maharaj Medical University, Lucknow 226003, Uttar Pradesh, India. garg50@yahoo.com <garg50@yahoo.com>No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20031301

Citation

Garg, Ravindra Kumar, et al. "Neurological Complications of Miliary Tuberculosis." Clinical Neurology and Neurosurgery, vol. 112, no. 3, 2010, pp. 188-92.
Garg RK, Sharma R, Kar AM, et al. Neurological complications of miliary tuberculosis. Clin Neurol Neurosurg. 2010;112(3):188-92.
Garg, R. K., Sharma, R., Kar, A. M., Kushwaha, R. A., Singh, M. K., Shukla, R., Agarwal, A., & Verma, R. (2010). Neurological complications of miliary tuberculosis. Clinical Neurology and Neurosurgery, 112(3), 188-92. https://doi.org/10.1016/j.clineuro.2009.11.013
Garg RK, et al. Neurological Complications of Miliary Tuberculosis. Clin Neurol Neurosurg. 2010;112(3):188-92. PubMed PMID: 20031301.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neurological complications of miliary tuberculosis. AU - Garg,Ravindra Kumar, AU - Sharma,Rohitash, AU - Kar,Alok Mohan, AU - Kushwaha,Ram Avadh Singh, AU - Singh,Maneesh Kumar, AU - Shukla,Rakesh, AU - Agarwal,Atul, AU - Verma,Rajesh, Y1 - 2009/12/23/ PY - 2009/01/17/received PY - 2009/11/05/revised PY - 2009/11/11/accepted PY - 2009/12/25/entrez PY - 2009/12/25/pubmed PY - 2010/6/17/medline SP - 188 EP - 92 JF - Clinical neurology and neurosurgery JO - Clin Neurol Neurosurg VL - 112 IS - 3 N2 - 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. SN - 1872-6968 UR - https://www.unboundmedicine.com/medline/citation/20031301/Neurological_complications_of_miliary_tuberculosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0303-8467(09)00310-2 DB - PRIME DP - Unbound Medicine ER -