Ibrahim Etedal Ahmed A, Ahmed Hamza Mohammed Nosiba Ibrahim Mohammed, Abbasher Hussien Mohamed Ahmed Khabab, A Manhal Gaffar Alemam, Mahmmoud Fadelallah Eljack Mohammed, Tahir Muhammad Junaid
Faculty of Medicine AlNeelain University Khartoum Sudan.
The National Center for Neurological Science Khartoum Sudan.
Health Sci Rep. 2023 Jan 19;6(1):e1068. doi: 10.1002/hsr2.1068. eCollection 2023 Jan.
BACKGROUND: Tuberculosis (TB) can involve almost any organ of the body. In the central nervous system (CNS), it can cause Pott's disease, meningitis, tuberculoma, abscess, or other manifestations. Tuberculosis is rampant in the developing world and has become a significant public health menace with the human immunodeficiency virus (HIV) dissemination. This study aimed to determine the frequency of neurological manifestations of tuberculosis among adult Sudanese patients. METHODOLOGY: A hospital-based cross-sectional study carried out in the period from September to December 2020 at multineurological centers and hospitals in Khartoum State, including Ibrahim Malik Teaching Hospital, Alshaab Teaching Hospital, Bashier, Abu Anga, Omdurman Teaching Hospitals, included adult patients diagnosed with tuberculosis-associated neurological manifestations. The data were collected by predesigned questionnaire, and then analyzed by computer using SPSS-version 25. RESULTS: A total of 43 patients were evaluated, male patients were 24 (55.8%) and female patients were 19 (44.2%). About 31 (72.1%) of the participants had extra-pulmonary TB and 12 (27.9%) had pulmonary and extrapulmonary TB. The neurological manifestations of tuberculosis include Pott's disease in 29 (67.4%) patients (with thoracic spine most affected part), tuberculoma was second-most, occurring in 8 (18.7%) patients (with a single lesion in most of the patients), whereas tuberculous meningitis was found in 6 (13.9%). Clinical presentation was headache in 14 (32.6%) patients, convulsions in 10 (23.3%), loss of consciousness in 9 (20.9%), hemiparesis in 7 (16.3%) patients, and paraparesis in 23 (53.5%). Cranial nerve affected in 5 (11.6%) patients. All patients received antituberculosis medication and steroids, and 10 (23.2%) received anticonvulsants. CONCLUSIONS: Neurological tuberculosis should be ruled out in any young male from an endemic area who exhibits abnormalities in motor, sensory, special sense, or higher mental function. To avoid potentially fatal complications, diagnoses and treatments should be initiated as soon as possible.
背景：结核病可累及身体几乎任何器官。在中枢神经系统（CNS）中，它可引起波特氏病、脑膜炎、结核瘤、脓肿或其他表现。结核病在发展中国家猖獗，随着人类免疫缺陷病毒（HIV）的传播，已成为重大的公共卫生威胁。本研究旨在确定成年苏丹患者中结核病神经学表现的发生率。 方法：2020年9月至12月在喀土穆州的多个神经科中心和医院开展了一项基于医院的横断面研究，其中包括易卜拉欣·马利克教学医院、阿尔沙布教学医院、巴希尔医院、阿布·安加医院、恩图曼教学医院，纳入了诊断为结核病相关神经学表现的成年患者。通过预先设计的问卷收集数据，然后使用SPSS 25版计算机进行分析。 结果：共评估了43例患者，男性患者24例（55.8%），女性患者19例（44.2%）。约31例（72.1%）参与者患有肺外结核，12例（27.9%）患有肺结核和肺外结核。结核病的神经学表现包括29例（67.4%）患者出现波特氏病（胸椎是最常受累部位），结核瘤次之，8例（18.7%）患者出现（大多数患者为单个病灶），而结核性脑膜炎有6例（13.9%）。临床表现为14例（32.6%）患者头痛，10例（23.3%）惊厥，9例（20.9%）意识丧失，7例（16.3%）患者偏瘫，23例（53.5%）截瘫。5例（11.6%）患者出现颅神经受累。所有患者均接受抗结核药物和类固醇治疗，10例（23.2%）接受抗惊厥药物治疗。 结论：对于来自流行地区且运动、感觉、特殊感觉或高级心理功能出现异常的任何年轻男性，均应排除神经结核。为避免潜在的致命并发症，应尽快进行诊断和治疗。
Clin Neuroradiol. 2018-9-17
Am J Case Rep. 2018-6-16
N Am J Med Sci. 2013-7
Neurosciences (Riyadh). 2016-4
J Prim Care Community Health. 2016-7
N Engl J Med. 2016-1-14
Lancet Neurol. 2013-8-23
Health Technol Assess. 2007-1
Int J Tuberc Lung Dis. 2007-1
Postgrad Med J. 1999-3
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