Highlights
- •Almost a quarter of the worldwide population is infected with tuberculosis.
- •Seizures are commonly associated with central nervous system (CNS) tuberculosis, especially in children and HIV-infected patients.
- •Early treatment of CNS tuberculosis is vital to avoid complications that increase the risk of seizures.
- •Young age, early onset of seizures during illness, refractory seizures, tuberculoma, cortical involvement, epileptiform discharges, and residual lesions, are risk factors for the development of epilepsy in CNS tuberculosis.
Abstract
Central nervous system (CNS) tuberculosis is a life-threatening condition that usually
presents with seizures, particularly in children and HIV-infected patients. Tuberculous
meningitis (TBM) and tuberculomas are the two forms of CNS tuberculosis that can present
with seizures. Seizures usually resolve after successful treatment of the underlying
infection. However, the success of the treatment is usually based on an early diagnosis.
Delay in the treatment of CNS tuberculosis increases the risk of its associated complications,
such as stroke. This would lead to the development of epilepsy. Early seizures may
be related to meningeal irritation and cerebral edema, whereas late seizures are often
associated with structural brain lesions that generally require more advanced and
prolonged treatment. Risk factors associated with the development of epilepsy include
young age, refractory seizures, tuberculoma, cortical involvement, epileptiform discharges,
and residual lesions. Treatment of CNS tuberculosis is based on early initiation of
appropriate anti-tuberculous drugs, antiseizure medications, and correction of associated
predisposing factors. Finally, further research into the mechanisms of seizures and
the development of epilepsy in CNS tuberculosis could help improve management of these
conditions.
Keywords
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Article info
Publication history
Published online: March 13, 2023
Accepted:
March 11,
2023
Received in revised form:
February 26,
2023
Received:
December 13,
2022
Identification
Copyright
© 2023 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
