Central Nervous System Tuberculosis (CNS-TB) refers to a collection of neurological syndromes resulting from Mycobacterium tuberculosis infection, carrying a significant risk of mortality and long-term health problems.
Here's a more detailed breakdown:
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Definition: CNS-TB occurs when Mycobacterium tuberculosis, the bacteria responsible for tuberculosis, infects the brain, spinal cord, or their surrounding membranes.
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Key Characteristics:
- High mortality and morbidity rates if left untreated.
- Diverse neurological manifestations, making diagnosis challenging.
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Common Presentations: CNS-TB can manifest in several ways, including:
- Tuberculous Meningitis: This is the most common form, involving inflammation of the meninges (membranes surrounding the brain and spinal cord). Symptoms may include headache, fever, stiff neck, and altered mental status.
- Tuberculoma: These are localized masses of tuberculous granulation tissue within the brain or spinal cord. They can cause seizures, focal neurological deficits (e.g., weakness, sensory loss), and increased intracranial pressure.
- Tuberculous Brain Abscess: A less common but serious condition involving a pus-filled cavity in the brain caused by tuberculosis.
- Pott's Disease: Tuberculosis of the spine, leading to vertebral destruction and potential spinal cord compression. This falls under CNS-TB when the spinal cord is affected.
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Diagnosis: Diagnosis often involves a combination of:
- Clinical evaluation: Assessing symptoms and neurological findings.
- Imaging studies: MRI or CT scans of the brain and spine.
- Cerebrospinal fluid (CSF) analysis: Examining CSF for signs of infection, including bacteria, white blood cells, and protein levels.
- Mycobacterial culture and PCR: Detecting Mycobacterium tuberculosis in CSF or other tissue samples.
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Treatment: Treatment typically involves a prolonged course of anti-tuberculosis medications, often lasting 6-12 months or longer. Corticosteroids may also be used to reduce inflammation. In some cases, surgery may be necessary to drain abscesses or remove tuberculomas.
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Outcome: Early diagnosis and treatment are crucial for improving outcomes in CNS-TB. However, even with appropriate treatment, some patients may experience permanent neurological deficits.
In summary, CNS-TB encompasses various severe neurological conditions caused by tuberculosis infection affecting the brain, spinal cord, or their membranes, requiring prompt diagnosis and treatment to minimize morbidity and mortality.
