Correlation of Serum Sodium at Admission with the Staging, Neurological Deficits and Imaging Abnormalities in Tuberculous Meningitis
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2018, Vol 3, Issue 4
Abstract
Tuberculous meningitis (TBM) is a major global health problem and is the most severe form of extrapulmonary tuberculosis with high mortality rate. Its reported prevalence varies from 5 to 15% in various cohorts of the population of patients with tuberculosis (Farer et al 1979, Wood et al 1998). Clinically, TBM is a syndrome of subacute lymphocytic meningitis in the majority of patients. In developing countries, TB meningitis is still a disease of childhood with the high incidence in the first three years of life (Tandon PN, Brattier R, Handbook of clinical neurology, Donald PR). Many complications are associated with tuberculous meningitis like vasculitis infarcts, hydrocephalus, cerebral atrophy, and tuberculomas. There are various cofactors associated with the various complications like CSF ADA levels and hyponatremia. Hyponatremia is seen in almost half of the patients with tuberculous meningitis. Various mechanisms are held responsible for the hyponatremia most common of them is cerebral salt wasting. Previous studies by Harold e Harrison et al (1) shows that in plasma the concentrations of sodium and chloride are reduced without any consistent change in the concentrations of the potassium. It has been seen that the more severe the hyponatremia, the more severe meningitis and severe the complications also seen associated with that. This study was done so as to see the relationship of the serum sodium levels with the staging of tuberculous meningitis and the neurological deficits along with the neurological imaging abnormalities seen in the scanning. Materials and Methods The study was a prospective study, done in the department of medicine and department of neurology from September 2015 to August 2016. The patients who got admitted with clinical picture commensurate with Meningitis in Medicine and Neurology department were assessed on Thwarts Criteria and those found to be likely cases of T.B.M, as per the criteria were included in the study and their serum sodium levels were measured. Inclusion Criteria • Those subjects who give informed consent for the study. • Patients fulfilling the diagnostic criteria of TBM based on the Thwarts criteria.
Authors and Affiliations
Gyan Ranjan Nayak
Keywords
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