[Clinical aspects, diagnosis and treatment of neurological complications of tuberculosis].

Data on 1112 tuberculosis patients with various neurological complications who were treated at Moscow Tuberculosis Clinical Hospital No. 7 during 1997-1999 are analyzed. A working classification of neurological complications in tuberculosis, which may be recommended to therapeutists, phthisiologists, and neurologists, is proposed. The leading neurological complications in nonspecific tuberculosis are described. The acute toxic encephalopathy syndrome that is characterized by a combination of impaired consciousness, meningeal syndrome without spinal fluid changes, epileptic seizures, disseminated neurological symptoms, disseminated intravascular coagulation syndrome, and high death rates holds the lead. Mono- and polyneuropathies of predominantly the lower extremities are frequently detectable in tuberculosis. Concomitant alcoholism, diabetes mellitus, and isoniazid treatment make their course poorer. Vascular abnormalities of the nervous system in patients with tuberculosis run much more favourably that in those without it. Mild forms of parkinsonism were observed in 3% of patients with tuberculosis, vascular dementia is detectable rarely (0.2%), strokes run without severe overall cerebral symptoms. The high incidence of neurological diseases in patients with tuberculosis requires that specialized departments of neurology should be set up at the institutes of tuberculosis and at multidisciplinary related hospitals. The tuberculosis curricula for students and postgraduate physicians should envisage additional sections to study diseases of the nervous system in tuberculosis.