[Tuberculous meningoencephalitis].

Abstract

Tuberculosis (TBC) in children is still a public health problem in developing countries. Its most serious complication in children is meningo-encephalitis (ME TBC), which is one of the main causes of death from TBC. The objective of this review is to outline its aetiopathological, clinical and prognostic characteristics and compare these with three studies made in our University between 1984 and the present time. METBC is always a complication secondary to an unknown (but often pulmonary) focus. The morbid anatomy of the deposit of basal exudate explains all the subsequent clinical findings. The data given in the literature regarding the commonest presentation, that of subacute or chronic meningo-encephalitis, is similar to our findings. However there are some differences. These are: a tendency to presentation in older children, much lower mortality, a long-term incidence of sequelae of less than 50% which is much less than would be expected (especially in certain areas of superior nerve function). With regard to treatment, we emphasize that the standard recommendation is still to use four drugs for twelve mouths. Although steroids have not been shown to be of use with regard to either mortality or morbidity, they continue to be given.