Nervous tuberculosis

Nervous tuberculosis's disease overview

Currently, although there have been many progress in prevention and treatment, tuberculosis is still a global public health issue. According to the global tuberculosis report of the World Health Organization (WHO) in 2012, an estimated 9 million new tuberculosis and 1.4 million deaths in 2011. The second largest death globally after HIV. In addition, the appearance of more cases of multi -resistant tuberculosis can lead to the risk of explosion of a new pandemic with a high mortality rate caused by tuberculosis bacteria itself.

In the tuberculosis, the central nervous system (LHTKTU), although it accounts for a low proportion of the cases of tuberculosis, is a dangerous tuberculosis because it is likely to cause High death. The two main types of LHTKTU are meninges (LMN) accounting for 0.5-1% of tuberculosis and tuberculosis tumors accounting for 40% of the brain tumors worldwide. The mortality rate due to the LHTTU can be up to 60-70% if the patient is not treated promptly and reasonably.

Causes of Nervous tuberculosis's disease

TB in general and LHTKTU in particular are caused by mycobacterium tuberculosis. Tuberculosis caused. M. tuberculosis is difficult to catch color with normal dyes and only catch color with Ziehl-Neelen dyes, so it is also known as anti-acid bacillus.

Symptoms of Nervous tuberculosis's disease

LHTKTU can be divided into many different forms, which is divided into two main groups: one is tuberculosis in the brain : including meningitis, tuberculosis, blood vessels, brain tumors, brain tumors,, TB brain abscess; And the other is the spinal tuberculosis: including Pott spinal disease and two limb paralysis, spinal cord tumors, and spinal cord tuberculosis. Among the common forms of clinically, meninges, tumors and spinal cord tuberculosis. Each LHTKTU has different clinical manifestations.

Clinical symptoms of meningeal tuberculosis

after a few weeks of infection to a few months, in adults and older children with non -specific physical symptoms, often fever, headache, stiff neck, vomiting vomiting and anorexia.

As for young children, the possible symptoms are underdeveloped, weight loss, fussing, anorexia, difficulty sleeping. One study found that up to 50 - 90% of children with typical neurological symptoms had a history of previous exposure to tuberculosis. Convulsions due to fever or no fever, paralysis or paralysis of nerves are also signs of meningeal tuberculosis in young children.

Clinical symptoms of tuberculosis tumor

clinical manifestations of tuberculosis depending on the anatomical position of tu tumor, but often asymptomatic. Symptoms, if any, are usually headache, fever and weight loss. Local convulsions or body convulsions can also be a common sign of both adults and children. Local neurological signs are less common but the abnormalities in motor, cerebellum and butterfly cavity are the most common signs in adults. In addition, some patients also have abnormal manifestations such as pituitary function, diarrhea and brain stem syndrome.

The clinical symptom of the spinal tuberculosis

tuberculosis bacteria can attack any part of the spinal cord including nerve roots so often causes symptoms related to the upper or lower nerve nerve. And there are many different characteristics.

About 10% of LMN cases have spinal tuberculosis. The vertebrae (Pott's disease) accounts for the majority of the spinal cord and the common signs of pain, tumor growth, and signs of spinal compression from the outside. The epidural spinal tuberculosis causes more than 60% of the mildly lower limb cases, although the tu tumor may appear in any part of the spine. Neuritis caused by rare tuberculosis but has also been recorded with typical primary muscle, nerve root pain, and bladder failure. Spinal hollow is a rare complication of the spine.

Transmission route of Nervous tuberculosis's diseaseNervous tuberculosis

Similar to the pulmonary tuberculosis, the transmission of the LHTTU is also the respiratory tract due to patients with mucus, saliva and healthy people inhaling these secretions. After the preliminary stage, tuberculosis bacteria along blood and lymphatic to cause meningeal and brain or the spinal cord thereby causing different forms of LHTKTU.

People at risk for Nervous tuberculosis's disease

Many studies in the world have shown that some factors may increase the risk of lhthtu. Age is an important risk factor because the LHTTu often occurs in children and HIV patients [10, 25, 28, 84]. Một số yếu tố khác cũng đã được chứng minh là làm tăng nguy cơ mắc LHTKTU ở trẻ em bao gồm suy dinh dưỡng và mắc bệnh sởi.

In adults, factors such as alcoholism, malignant tumors and immunosuppressive drugs are risk factors. A number of studies in developed countries also found that citizens from other countries migrated to that country to live or citizens of that country but were born in developing countries, which are two groups of objects. There is also a high risk of LHTTTT.

Prevention of Nervous tuberculosis's disease

The best way to prevent tuberculosis is to prevent tuberculosis by using Bacillus calmette-guérin vaccine (BCG) that can help control the spread of the disease . This vaccine is effective to control tuberculosis infections in young children.

Treatment for people with tuberculosis infections inactive or inactivated can also help control the spread of the disease. The infection is not active or inactive is when a tester is positive for tuberculosis, but there is no symptom of the disease. People with inactive tuberculosis still have the ability to transmit disease.

Diagnostic measures for Nervous tuberculosis's disease

Diagnosis of meningeal tuberculosis

Analysis of cerebrospinal fluid. Cerebrospinal fluid will be extracted from the patient through the procedure of spinal cord detection. When analysis of cerebrospinal fluid, we can diagnose LMN based on cytological and microbiological aspects.

Molecular biochemistry technique. Stemming from the fact that traditional methods often do not achieve optimal effectiveness and have a long return time, many biochemical and molecular techniques used in tuberculosis have been applied. Go to lhtktu diagnosis.

Biochemical test. Currently, in the laboratories of many developed countries, it is possible to perform an ADA enzyme test in the cerebrospinal fluid of patients with LMN. Men ADA is considered as a point for immune activity through cell intermediaries because it is present with the proliferation of lymphocytes in the patient's cerebrospinal fluid.

Testing for detection of antibodies of tuberculosis bacteria. Testing detected tuberculosis antigen is more beneficial than antibody tests in that it only returns results in case the patient's body has immune response or when the treatment has results. This method has also been shown to be more sensitive than the PCR method.

Skin test. The positive diagnostic value of the skin test is very fluctuated: In some studies, it is found that only 10-20% of LMN patients have positive results

Image diagnostic includes X-ray, CT scan and MRI scan.

Diagnosis of brain tumor

Cerebrospinal fluid analysis. Cerebral tumor is a lhthtu disease that is very difficult to distinguish from other types of brain cavity damage if only based on clinical symptoms. Therefore, the analysis of the cytotoxic aspect of cerebrospinal fluid is essential

Image diagnostic methods with MRI and abdominal CT, pelvis and chest can provide additional evidence of untreated tuberculosis lesions by X shooting method Traditional optical. MRI can help detect small lesions and lesions of the posterior and brain body.

Diagnosis of spinal tuberculosis

Cerebrospinal fluid analysis. Like in tuberculosis tumors, tissue biopsy is a more valuable method than direct screening methods or culture because the number of tuberculosis bacteria in the cerebrospinal fluid is very small.

MRI technique is recommended by many scientists in the diagnosis of spinal tuberculosis because it helps the doctor can make a decision whether to have surgery or not and it is also very very The value in the use to monitor after treatment.

Nervous tuberculosis's disease treatments

Treatment of lhthtu or meningeal tuberculosis is now recommended according to the pulmonary treatment regimen, that is, the attack in the early stages and then the stage of continuous drug treatment. The four drugs are currently recommended to be used in the treatment of LHTKTU including isonazid, Rifampicin, Pyrazinamide and Ethambutol are taken daily according to the monotherapy regimen or combined with many drugs together.

Regarding the length of treatment time, a study has concluded that six months of treatment is the appropriate time to treat the LHTTTU. However, most of the medical management agencies recommend that patients should be treated for 12 months because the patient's recovery depends on factors such as the severity of the disease, the penetrating ability of The drug in cerebrospinal fluid, bacterial resistance and cooperation in patient treatment. The patient must be treated at least 10 months. The treatment time may last up to 12 months in patients who fail because they do not respond to the drug or if the treatment is interrupted for any reason.

See also:

Genital urinary system: Causes, symptoms, diagnosis and treatment

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