Natural course of epilepsy concomitant with CNS tuberculomas

Abstract

Epilepsy is relatively common in CNS tuberculomas, but its natural course is unclear. To determine the prevalence and prognosis of epilepsy in patients with seizures related to CNS tuberculomas. We retrospectively reviewed the charts of patients with CNS tuberculomas who presented at our institution between 1983 and 2001. Seizures occurred in 22 of 93 (23.6%) of the patients with CNS tuberculomas. These patients were treated with standard antituberculous therapy for a period varying between 6 and 20 months. Sixty-three out of 93 patients were cured of tuberculosis, and 21 of the 63 (33%) who had concomitant epilepsy became seizure-free. TB recurred in 3 patients, and 1 out of 22 who had concomitant epilepsy continued to have seizures; 3 died and 24 were lost to follow-up. Anti-epileptic medications were discontinued after completion of the anti-TB course. Seizures are commonly associated with CNS tuberculomas and most often resolve after successful treatment of the underlying CNS tuberculosis.