关键词: 结核脑膜

Abstract: Objective To summarize the diagnosis and treatment of atypical tuberculosis meningitis.Methods The clinical data of 62 cases with atypical tuberculosis meningitis were retrospctively analyzed.Results The group of cases does not show any tupical symptoms of tuberculosis meningitis.Their clinical manifestations were as follows:disturbance of consciousness in 17 cases(27.4%),dizziness and low fever in 47 cases(75.8%),tiredness and depression in 13 cases(21.0%),limbs numbness in 21 cases(33.9%),paralysis in 5 cases(8.1%),damage of cranial nerve in 18 cases(29.0%),urinary retention in 10 cases(16.1%),epileptic-like attack in 4 cases(6.5%).Thoracic iconography examination are positive in 37 cases(59.7%),Skull iconography examination are positive in 13 cases(21%).The Results of cerebrospinal fluid examination are as follows:content of glucose decreasing in 30 cases(48.4%),content of chloride decreasing in 32 cases(51.6%),content of protein increasing in 36 cases(58.1%);adenylate deaminase (ADA) being positive in 58 cases(93.5%);tuberculosis antibody being positive in 48 cases(77.4%);smear acid-fast bacillus being positive in 2 cases(3.2%).62 patients were cured of and 1 patient died.Conclusion The clinical manifestation of atypical tuberculosis meningitis lacked of specificity,and the changes of cerebrospinal fluid are atypical.But positive reaction of tuberculosis antibody in cerebrospinal fluid could act as a reference in diagnosing tuberculosis of central nervous system,and adenylate deaminase is a sensitive and specific indes in diagnosis.Examinations of laboratory and iconography are important to confirmed diagnosis,standard antituberculosis treatment combined with intrathecal injection will have satisfied ellect.

Key words: Meningitis Tuberculosis