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Chapter 73 - Tuberculosis

from Section 3 - Symptomatic epilepsy

Published online by Cambridge University Press:  05 March 2012

Simon D. Shorvon
Affiliation:
National Hospital for Neurology and Neurosurgery, London
Frederick Andermann
Affiliation:
Montreal Neurological Hospital and Institute
Renzo Guerrini
Affiliation:
Child Neurology Unit, Meyer Pediatric Hospital, Florence
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Summary

This chapter presents the epidemiology, clinical features, diagnosis and principles of the management for tuberculosis. History of contact with and the presence of pulmonary tuberculosis on chest X-ray are more often found in children than in adults. Children less often complain of headache and more often have hydrocephalus. The tuberculin skin test and its immunological equivalent with blood, the interferon-gamma releasing assay (IGRA) which measures interferon-gamma release by T cells, both measure development of cell-mediated immunity after exposure to Mycobacterium tuberculosis. Neurotuberculosis is associated with an increased risk of epilepsy. Risk of epilepsy is higher if there were early seizures and particularly status epilepticus. The differential diagnosis includes all other causes of central nervous system (CNS) infection, bacterial meningitis, viral meningoencephalitis, cerebral malaria, fungal meningitis, and even non-infective causes. The first-line antiepileptic drugs (AEDs), phenytoin, carbamazepine, valproate, and phenobarbitone, are most widely used in developing countries.
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The Causes of Epilepsy
Common and Uncommon Causes in Adults and Children
, pp. 511 - 519
Publisher: Cambridge University Press
Print publication year: 2011

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