Abstracts

Rationale: Tuberculosis is an infectious disease of global epidemic proportions that can affect multiple organs. Tuberculomas are the main manifestation of intracranial tuberculosis infection. Tuberculomas may also occur as a result of a paradoxical reaction. It is an uncommon etiology to induce epilepsy, which can be attributed to infectious etiology and structural etiology. In this study, we intend to analyse the clinical features of epilepsy induced by intracranial tuberculoma. And we explored the specificity of tuberculoma of paradoxical response.

Epilepsy surgery is a routine method using surgical techniques to treat epilepsy. There are few reports on the use of epilepsy surgery in this condition. We analysed the indication for surgery and the effectiveness of surgery in this condition. What is special and essential is that the safety of surgery requires anti-tuberculosis therapy in the perioperative period. So we summarised the therapy plan after tuberculoma surgery.


Methods: We reported a case of epilepsy induced by tuberculoma in the temporal lobe, which may be the result of a paradoxical reaction. We also conducted a literature review of case reports based on the PubMed database. Included cases are patients who underwent epilepsy surgery for epilepsy induced by intracranial tuberculoma. We collected information on these cases and analysed the clinical features, surgical methods and outcomes.


Results: Eight cases were included in this research, including the case we reported. Three of them had a history of tuberculosis meningitis. The most common type of seizure is generalised seizure. The patient we reported had a focal seizure. Half of the patients have a solitary lesion. The most common brain region involved is the frontal lobe. All the patients underwent resection surgery and anti-tuberculosis therapy was administered after surgery. At follow-up, all patients had complete resolution of their symptoms.


Conclusions: The clinical features of childhood epilepsy caused by tuberculoma are similar to the common structural abnormalities in childhood epilepsy. And it will develop into intractable epilepsy. The basic rules of epilepsy surgery also apply to tuberculoma epilepsy. Resection of epileptic foci makes sense if the seizures caused by the tuberculoma correspond to the indications for epilepsy surgery. After resection surgery, empirical ATT is recommended to prevent severe outcome caused by infection spreading.


Funding: This research did not receive any specific grant from funding agencies.