Tuberculosis: A More Than One Pathophysiology to Induce Neurological Disorder

Tuberculosis (TB) is an infectious disease which can infect all body organs including the central nervous system (CNS). TB has a higher mortality rate worldwide and is a frequent cause of neurologic sequelae. Approximately 10% of TB patients also have a CNS involvement. CNS-TB can take several clinical forms; Therefore, this review concentrates on the most prevalent types of CNS-TB because it is one of the most severe forms of extrapulmonary tuberculosis. Tuberculous meningitis is the most common type of CNS tuberculosis. The patient presents with insidious chronic meningitis or acute fulminant meningitis. Hydrocephalus is usually associated, especially in children, Intracranial vasculopathy, which is a serious complication of Tuberculous meningitis that can cause stroke. CNS tuberculomas is a hard-granulomatous mass that is commonly presented with focal neurologic impairments depending on its location, along with symptoms and signs of increased intracranial pressure. Tubercular Brain Abscess and Tuberculous Encephalopathy are uncommon clinical presentations of CNS tuberculosis; they usually affect children and HIV patients. Spinal TB (Pott illness) is a common form of skeletal TB that usually affects the thoracic and lumbar spines; if the cervical spine is affected, potentially fatal neurological consequences can occur. The definitive diagnosis of CNS tuberculosis is usually based on examining the CSF (as with TB meningitis) and being evaluated by neuroimaging are often the two main components of the final diagnosis of CNS tuberculosis (CT, MRI). Empirical anti-tuberculous medication, steroids, and only in exceptional circumstances, surgery, are used to treat patients.