A Case of Tuberculous Meningoencephalitis Presenting as Prominent Psychotic Features.

Yu, Hyun Jung; Oh, Jee Young; Kim, Jee Hyun; Kim, Jung Eun; Park, Kee Duk

doi:2001.51.6.603

Tuberc Respir Dis > Volume 51(6); 2001 > Article

Case Report

Tuberculosis and Respiratory Diseases 2001;51(6):603-608.
DOI: https://doi.org/10.4046/trd.2001.51.6.603 Published online December 1, 2001.

A Case of Tuberculous Meningoencephalitis Presenting as Prominent Psychotic Features.

Hyun Jung Yu, Jee Young Oh, Jee Hyun Kim, Jung Eun Kim, Kee Duk Park

Abstract

Intracranial vasculitis is a rare and disastrous complication of tuberculous meningitis if not treated properly. Focal neurologic deficits according to the vessels involved are common manifestation. Here, we report a 29-year-old man who suffered abrupt, bizarre behavioral changes caused by vasculitis complicating tuberculous meningoencephalitis. The diagnosis of tuberculous meningitis is based upon both the CSF findings and a chest X-ray. His systemic symptoms disappeared by after being administered antituberculous medication but various psychotic features such as hypersomnia, hyperphagia and aggressivebehavior continued. A brain MRI showed multiple small parenchymal tuberculous nodules, and the brain MR angiography revealed a narrowing of the proimal middle cerebral arteries and a reduced visualization of the cerebral vessels, suggesting widespread vasculitis. Intravenous dexamethasone successfully ameliorated his behavioral changes. In addition both the follow up brain MRI and angiography showed a normalization of the previous findings.

Key Words: Tuberculosis, Vasculitis, Meningoencephalitis