[Neurotuberculosis: a continuing clinical challenge].
In Germany neurotuberculosis is quite rare. Familiarity with the disease is nonetheless important because of many differential diagnoses and therapeutic implications. The diagnosis of neurotuberculosis is made by considering of clinical presentation, CSF, and cerebral imaging. Early diagnosis, prompt initiation of effective antitubercular therapy, and clinical staging are necessary for establishing a long-term treatment prognosis. The results of neurotuberculosis therapy are often unsatisfactory despite the availability of effective drugs. Lasting damage or death can be averted in fewer than half of the patients. Studies now confirm that early adjuvant corticoid therapy reduces lethality and morbidity. Resistant new strains of the pathogen, Mycobacterium tuberculosis, complicate therapy. Recent discoveries especially in diagnosis and therapy are explained using case evidence.
Klinik für Neurologie, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany. bruno-marcel.mackert@vivantes.de
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Mackert
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Conradi
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Loddenkemper
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van Landeghem
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Loddenkemper
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R
Ignatius
T
T
Schneider
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000995:Antitubercular Agents / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D013116:Spinal Cord / Q000473:pathology; D016862:Tuberculoma, Intracranial / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D014390:Tuberculosis, Meningeal / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology
D000305:Adrenal Cortex Hormones; D000995:Antitubercular Agents