title: Treatment of central nervous system tuberculosis infections and neurological complications of tuberculosis treatment.
abstract: Tuberculosis (TB) with central nervous system (CNS) manifestation is a form of TB with a high mortality and morbidity. Tuberculous meningitis (TM) is the most common form of CNS-TB. Although diagnosis of CNS-TB can be challenging, early treatment of CNS-TB is related to a better outcome. If CNS-TB is suspected, even though the clinical picture is not specific, it should be immediately treated. For the treatment of CNS-TB, knowledge of the penetration across the blood-brain barrier of the various antituberculosis agents used in TB treatment is important. These will be described here in order to serve as a guide in choosing a treatment for CNS-TB. Corticosteroids have an evidence-based value in the treatment of TM and so are recommended. As for thalidomide use in CNS-TB, sound evidence is still lacking. We will also include a description of the adverse neurotoxic effects of the various other agents including their psychiatric, ototoxic and ophthalmic adverse effects.
authors.affiliation: Department of Neurology University Medical Center Groningen, The Netherlands. J.J.van.der.Harst@umcg.nl
authors.forename: J J
authors.initials: JJ
authors.lastname: van der Harst
authors.forename: G J
authors.initials: GJ
authors.lastname: Luijckx
mesh_terms: D000818:Animals; D000995:Antitubercular Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001812:Blood-Brain Barrier / Q000378:metabolism*; D019317:Evidence-Based Medicine; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D020258:Neurotoxicity Syndromes / Q000209:etiology; D014018:Tissue Distribution; D016896:Treatment Outcome; D020306:Tuberculosis, Central Nervous System / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D014390:Tuberculosis, Meningeal / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology
chemical_list: D000995:Antitubercular Agents; D005938:Glucocorticoids