Natural course of epilepsy concomitant with CNS tuberculomas.

Background: Epilepsy is relatively common in CNS tuberculomas, but its natural course is unclear.

Aim: To determine the prevalence and prognosis of epilepsy in patients with seizures related to CNS tuberculomas.

Methods: We retrospectively reviewed the charts of patients with CNS tuberculomas who presented at our institution between 1983 and 2001.

Results: 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.

Conclusion: Seizures are commonly associated with CNS tuberculomas and most often resolve after successful treatment of the underlying CNS tuberculosis.