Central Nervous System TB
・Meningitis most frequent form of CNS TB; solitary or multiple tuberculomas less frequent
・Presumably result from direct seeding and proliferation during a TB bacillemia either at time of initial infection or during breakdown of old CNS focus
・Epidemiology of CNS TB
- Peak incidence in infants and children up to 4 years old
- Occur in greater frequency among HIV-infected persons, especially for tuberculoma
CNS TB: Clinical Presentation
・General findings
- In adults, headache, fever, and meningeal sign
- In children, nausea and abdominal complaints more prominent and headache less frequent, irritable behavior
- Drowsiness and lethargy
・Focal neurologic findings
- Cranial nerve palsies
- Paresis or paralysis
・Meningeal sign in children
- Flexing the hip and knees and then try to extend the knees with hip flexed result in child extending his neck and back
