Lv. Lee, Neurotuberculosis among Filipino children: an 11 years experience at the Philippine Children's Medical Center, BRAIN DEVEL, 22(8), 2000, pp. 469-474
Tuberculous meningitis (TBM) remains the most common form of neurotuberculo
sis in children. Four hundred and five cases of tuberculous meningitis (age
s 3-156 months) seen at the Philippine Children's Medical Center (PCMC) fro
m 1987 to 1998 were reviewed. Inclusion criteria include clinical and labor
atory profile of TBM with pertinent evidence on imaging such as computed to
mography and/or cranial sonography or histologic evidence of TBM. Nearly ha
lf of the cases were below age 2. The most common neurologic findings were
altered sensorium, neck rigidity, motor and cranial deficits. The mortality
rate was 16%. The neuropathologic findings in 31 autopsied cases were basa
l exudates in 100%, hydrocephalus in 71%, caseation necrosis in 68%, and 35
% with infarcts. The most important determinant of outcome is the stage of
illness at which the diagnosis is made and appropriate treatment is given.
Although computed tomography was more definitive, cranial sonography was a
very useful diagnostic tool considering the frequent occurrence below age 2
. A short course (6 months) anti-tuberculous therapy for neurotuberculosis
wan shown to be adequate: shunting of cases with hydrocephalus did not show
definite benefit. (C) 2000 Published by Elsevier Science B.V. All rights r
eserved.