The Italian Journal of Neurological Sciences

, Volume 10, Issue 2, pp 163–170 | Cite as

Reversible multifocal encephalopathy following tuberculous infection

  • Provinciali L. 
  • Pesce M. Del 
  • Censori B. 
  • Pasquini U. 
Original Articles


Tuberculous encephalic infection is commonly reported as confined to Asians or Africans or people living in poor hygienic conditions; very often it follows meningitis in patients with lung TB infection. We describe three western patients coming from good social environment and suffering from multifocal tuberculous encephalopathy. Two of them showed neither meningitis or lung TB when CNS involvement appeared. Complete recovery after therapy is described, together with the evolution of brain CT and, in 1 case, MRI features. The instrumental findings accompanying the complete recovery suggest that the lesions described in these cases are a localized form of encephalitis responsive to medical treatment, unlike tuberculomas, which often need surgical treatment. The occurrence of tuberculous encephalic infection in western, middle-class patients with or without meningitis emphasizes that tuberculous encephalopathy must be considered in the differential diagnosis of multifocal brain lesions.


Tuberculous encephalopathy tuberculomas localized encephalitis computed tomography magnetic resonance imaging 


L'infezione encefalica tubercolare è comunemente descritta come esclusiva di individui asiatici o africani, o di soggetti che vivono in scadenti condizioni igieniche; molto spesso essa segue la meningite nei pazienti con evidente tubercolosi polmonare. Vengono qui descritti tre casi di encefalopatia tubercolare multifocale in pazienti italiani di buona condizione socio-economica. Due di essi non mostravano né meningite né tubercolosi polmonare quando comparvero i segni di compromissione del S.N.C.

In particolare viene descritto il completo recupero dopo terapia medica e vengono riportate le caratteristiche TAC e, in un caso, di Risonanza Magnetica Nucleare. I dati strumentali suggeriscono che questi casi rappresentano una forma localizzata di encefalite, sensibile al trattamento medico, a differenza dei tubercolomi che richiedono spesso il trattamento chirurgico. Il verificarsi di infezione encefalica tubercolare in pazienti occidentali di buon livello socio-economico suggerisce che la encefalopatia tubercolare deve rientrare nella diagnosi differenziale delle lesioni cerebrali multifocali.


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Copyright information

© Masson Italia Periodici 1989

Authors and Affiliations

  • Provinciali L. 
    • 1
  • Pesce M. Del 
    • 1
  • Censori B. 
    • 1
  • Pasquini U. 
    • 2
  1. 1.Istituto delle Malattie del Sistema NervosoUniversità di AnconaItaly
  2. 2.Servizio di Neuroradiologia U.S.L.12 di AnconaItaly

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