A Case of Tuberculous Meningoencephalitis Presenting as Prominent Psychotic Features.
10.4046/trd.2001.51.6.603
- Author:
Hyun Jung YU
;
Jee Young OH
;
Jee Hyun KIM
;
Jung Eun KIM
;
Kee Duk PARK
- Publication Type:Case Report
- Keywords:
Tuberculosis;
Vasculitis;
Meningoencephalitis
- MeSH:
Adult;
Angiography;
Brain;
Dexamethasone;
Diagnosis;
Disorders of Excessive Somnolence;
Follow-Up Studies;
Humans;
Hyperphagia;
Magnetic Resonance Imaging;
Meningoencephalitis*;
Middle Cerebral Artery;
Neurologic Manifestations;
Thorax;
Tuberculosis;
Tuberculosis, Meningeal;
Vasculitis
- From:Tuberculosis and Respiratory Diseases
2001;51(6):603-608
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Intracranial vasculitis is a rare and disastrous complication of tuberculous meningitis if not treated properly. Focal neurologic deficits according to the vessels involved are common manifestation. Here, we report a 29-year-old man who suffered abrupt, bizarre behavioral changes caused by vasculitis complicating tuberculous meningoencephalitis. The diagnosis of tuberculous meningitis is based upon both the CSF findings and a chest X-ray. His systemic symptoms disappeared by after being administered antituberculous medication but various psychotic features such as hypersomnia, hyperphagia and aggressivebehavior continued. A brain MRI showed multiple small parenchymal tuberculous nodules, and the brain MR angiography revealed a narrowing of the proimal middle cerebral arteries and a reduced visualization of the cerebral vessels, suggesting widespread vasculitis. Intravenous dexamethasone successfully ameliorated his behavioral changes. In addition both the follow up brain MRI and angiography showed a normalization of the previous findings.
