What are the presentation and clinical stages of chronic tuberculous meningitis?

Updated: Jul 16, 2019
  • Author: Rodrigo Hasbun, MD, MPH; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

The presentation of chronic tuberculous meningitis may be acute, but the classic presentation is subacute and spans weeks. Patients generally have a prodrome consisting of fever of varying degrees, malaise, and intermittent headaches. Cranial nerve palsies (III, IV, V, VI, and VII) often develop, suggesting basilar meningeal involvement.

Clinical staging of tuberculous meningitis is based on neurologic status, as follows:

  • Stage 1 - No change in mental function, with no deficits and no hydrocephalus

  • Stage 2 - Confusion and evidence of neurologic deficit

  • Stage 3 - Stupor and lethargy


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