Department of Neurology, Yonsei University College of Medicine, 134 Sinchon-dong, Seoul, Republic of Korea.
Eur Neurol. 2011;65(3):156-9. doi: 10.1159/000324170. Epub 2011 Mar 2.
Tuberculous encephalopathy (TBE) is an established disease entity of diffuse cerebral damage occurring with tuberculosis and an underlying immune pathogenesis. However, the presence of this disease entity remains controversial. We report a 15-year-old boy with seizures and a progressive decline of cognitive function. Brain MRI showed diffuse, hyperintense lesions in the white matter on a T2-weighted image, with gadolinium enhancement on a T1-weighted image. Brain biopsy revealed demyelination and granuloma in the white matter. Ziehl-Neelsen staining showed acid-fast bacilli in the granulomas. Antituberculous medication with concomitant steroid treatment resulted in radiological resolution in addition to clinical improvement. Clinicopathological evidence in this case provides additional convincing evidence of TBE as a disease entity distinct from tuberculous meningitis.
结核性脑病（TBE）是一种已确立的弥漫性脑损伤疾病实体，与结核病和潜在的免疫发病机制有关。然而，这种疾病实体的存在仍然存在争议。我们报告了一例 15 岁男孩，他有癫痫发作和认知功能进行性下降的病史。脑 MRI 显示 T2 加权图像上的白质弥漫性高信号病变，T1 加权图像上钆增强。脑活检显示白质脱髓鞘和肉芽肿。齐尔-尼尔森染色显示肉芽肿中有抗酸杆菌。抗结核药物联合皮质类固醇治疗除了临床改善外，还导致放射学缓解。本例的临床病理证据提供了额外的令人信服的证据，证明 TBE 是一种与结核性脑膜炎不同的疾病实体。
