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ISSN (Print): 1381-6128
ISSN (Online): 1873-4286

Treatment of Central Nervous System Tuberculosis Infections and Neurological Complications of Tuberculosis Treatment

Author(s): J. J. van der Harst and G. J. Luijckx

Volume 17, Issue 27, 2011

Page: [2940 - 2947] Pages: 8

DOI: 10.2174/138161211797470237

Price: $65

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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.

Keywords: Tuberculosis, central nervous system, tuberculous meningitis, antituberculosis agents, blood-brain barrier, corticosteroids, thalidomide, adverse neurotoxic effects, HIV infection, enzyme-linked immunospot assay (ELISpot assay)

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