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Child's Nervous System
Published in: Child's Nervous System 10/2018

01-10-2018 | Special Annual Issue

Tuberculosis of the central nervous system in children

Authors: Dattatraya Muzumdar, Rajshekhar Vedantam, Deopujari Chandrashekhar

Published in: Child's Nervous System | Issue 10/2018

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Abstract

Background

Central nervous system tuberculosis (CNS TB) in children is still a socioeconomic problem in developing countries. It has varied manifestations, symptoms are nonspecific, diagnosis can be challenging, and treatment may be difficult. It is often missed or overlooked. Among the various pathological entities, tuberculous meningitis is the most common and devastating manifestation. The resultant vasculitis, infarction, and hydrocephalus can be life-threatening. It can have grave cognitive, intellectual, and endocrine sequelae if not treated in time resulting in handicap, especially in resource constraint countries. Early diagnosis and treatment of tuberculous meningitis is the single most important factor determining outcome. Tuberculous hydrocephalus needs to be recognized early, and cerebrospinal fluid diversion procedure needs to be performed in adequate time to prevent morbidity or mortality in some cases. Tuberculous pachymeningitis and arachnoiditis are rare in children. Tuberculous abscess can mimic pyogenic abscess and requires high index of suspicion. Calvarial tuberculosis is seen in children and responds well to antituberculous chemotherapy. Drug-resistant tuberculosis is a formidable problem, and alternate chemotherapy should be promptly instituted.

Aim

The pathogenesis, clinical features, diagnosis, and management of central nervous system tuberculosis in children are summarized.

Conclusion

Heightened clinical suspicion, early diagnosis, appropriate antituberculous treatment, and surgery in relevant situation are essential for a gratifying outcome and preventing complications.
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Metadata
Title
Tuberculosis of the central nervous system in children
Authors
Dattatraya Muzumdar
Rajshekhar Vedantam
Deopujari Chandrashekhar
Publication date
01-10-2018
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 10/2018
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-018-3884-9

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