Neurologic Complications of Tuberculosis

Area of Science:

• Neurology
• Infectious Diseases
• Public Health

Background:

• Central nervous system (CNS) tuberculosis (TB) is a significant global health issue.
• It is associated with high mortality rates and long-term neurologic deficits.
• Human immunodeficiency virus (HIV) co-infection increases the risk and severity of CNS TB.

Purpose of the Study:

• To review the current epidemiology of CNS TB.
• To outline common clinical characteristics of neurologic TB complications.
• To discuss evidence-based diagnostic and management strategies.

Main Methods:

• Literature review of current epidemiology.
• Analysis of clinical characteristics.
• Evaluation of diagnostic and treatment evidence.

Main Results:

• CNS TB remains prevalent globally, with high mortality and sequelae, particularly in HIV-co-infected individuals.
• Stroke is a common complication of tuberculous meningitis; aspirin may be beneficial.
• Emerging diagnostic tools show promise but require further validation; current nucleic acid amplification tests have suboptimal sensitivity.
• Novel treatment strategies are under investigation, including specific drug combinations.

Conclusions:

• Neurologic TB presents diverse manifestations with substantial mortality.
• Diagnosis is difficult in endemic areas, often leading to empiric treatment.
• Optimal treatment regimens are uncertain, and the role of steroids in HIV-positive patients with tuberculous meningitis is debated.