Epileptic Disorders
MENUSeizure heralding tuberculous meningitis Volume 14, numéro 3, September 2012
Illustrations
- Mots-clés : acute symptomatic seizure, EEG, heraldic seizure, magnetic resonance imaging, tuberculous meningitis
- DOI : 10.1684/epd.2012.0516
- Page(s) : 329-33
- Année de parution : 2012
Seizures may frequently occur during tuberculous meningitis. We describe a patient with an apparent generalised tonic-clonic seizure, initially not associated with any magnetic resonance imaging (MRI) abnormality, which was the presenting symptom of tuberculous meningitis. Follow-up MRI, performed after gadolinium administration, showed signs of meningeal involvement. Seizures may be the presenting symptoms of tuberculous meningitis even in the absence of evident intracerebral lesions on MRI. Therefore, contrast-enhanced brain MRI should be performed in the diagnostic workup for each first seizure, especially in patients with a clinical suspicion of CNS infectious disease. The term “heraldic seizure”, indicating a subset of acute symptomatic seizures presenting at the onset of a brain/systemic injury or preceding the full clinical manifestation of a cerebral insult, may be helpful to classify these seizures retrospectively, based initially on unknown aetiology.