title: Neurological and systemic complications of tuberculous meningitis and its treatment at Auckland City Hospital, New Zealand.
abstract: Mortality and serious long-term sequelae still occur in about 50% of patients with tuberculous meningitis. The frequency and the clinical features of neurological and systemic complications were determined in a retrospective review of 104 patients with tuberculous meningitis. Complications occurred in 81 patients (78%). The most common complications were: hyponatraemia 49%, hydrocephalus 42%, stroke 33%, cranial nerve palsies 29%, epileptic seizures 28%, diabetes insipidus 6%, tuberculoma 3%, myeloradiculopathy 3% and hypothalamic syndrome 3%. The most common iatrogenic complication was hepatotoxicity related to anti-tuberculosis treatment in seven patients. Twenty-three patients (22%) died. At last follow-up one patient (1%) remained in a persistent vegetative state, 14 patients (13%) had severe disability and 12 patients (12%) were moderately disabled. The most common complications in the 81 long-term survivors were cognitive impairment (12%) and epilepsy (11%). Neurological and systemic complications of tuberculous meningitis were common and were important causes of mortality and long-term morbidity.
authors.affiliation: Department of Neurology, Auckland City Hospital, Private Bag 92024, Auckland, New Zealand. neila@adhb.govt.nz
authors.forename: N E
authors.initials: NE
authors.lastname: Anderson
authors.forename: J
authors.initials: J
authors.lastname: Somaratne
authors.forename: D F
authors.initials: DF
authors.lastname: Mason
authors.forename: D
authors.initials: D
authors.lastname: Holland
authors.forename: M G
authors.initials: MG
authors.lastname: Thomas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006786:Hospitals, Urban / Q000639:trends*; D006801:Humans; D006849:Hydrocephalus / Q000453:epidemiology / Q000209:etiology; D007010:Hyponatremia / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology; D007223:Infant; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology*; D009520:New Zealand / Q000453:epidemiology; D012189:Retrospective Studies; D020521:Stroke / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology; D014390:Tuberculosis, Meningeal / Q000150:complications* / Q000453:epidemiology / Q000628:therapy*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents