Risk Factors and Clinical Presentations of CNS Tuberculosis in a Population Attending a Tertiary Hospital

Abstract

Introduction: Tuberculosis is a granulomatous disease the incidence of which is on the rise due to new emerging contributing factors like The acquired immunodeficiency syndrome epidemic, emergence of multidrug-resistant strains, and immigration of people from endemic areas .

Aim: To study the risk factors and clinical presentations of CNS tuberculosis in a population attending a tertiary care hospital.

Material And Methods: The study was  retrospective for a period of 8 years( May 2001 to May 2009) and  prospective  for a period of 2 years ( May 2009 to May 2011).The clinical details of these patients were noted especially patient particulars, history(present,past & relevant),clinical features& investigations done. Various risk factors in these cases were studied Patients suffering from tubercular meningitis were excluded from this study.

Observations: Past history of tuberculosis was present in 23(25.55%) and family history of tuberculosis in 10(11.11%). In 44 cases (48.88%) no significant risk factor was noted. Chief symptoms of brain tuberculosis were convulsions  (65.60%),headache(56.25%),fever(37.5%),vomiting(25%),visual impairment(9.3%) and weakness (25%).25% of patients were normal on clinical examination.Motor deficit was found in (37.5%),urinary incontinence(9.3%), ptosis(12.5%) and cranial nerve palsies in (18.75%) of cases.

Conclusion: Past history of tuberculosis was the major risk factor for development of CNS Tuberculosis.So the emphasis is proper management of every tuberculous patient so that future risk of CNS involvement is minimized.Convulsions and headache were the most common symptoms in brain tuberculosis.