Published Paper Details:

Tuberculous meningitis (TBM) is an air-borne infectious disease caused by the bacteria Mycobacterium tuberculosis that affects the central nervous system (CNS). Among all the incident cases of Tuberculosis (TB), Central Nervous System Tuberculosis (CNS TB) represents approximately 1% with Tuberculous Meningitis (TBM) as the most grievous among all. Tuberculous meningitis results from the haematogenous spread of primary and postprimary pulmonary Tuberculosis (TB) or from the rupture of a sub-ependymal tubercule into a subarachnoid space.In more than half of cases, evidence of pulmonary lesions or a military pattern is found on CXR. The disease often presents subtly as headache and slight mental changes after a prodrome of weeks of low grade fever, malaise, anorexia, weight loss and irritability. If not recognized , tuberculous meningitis may evolve acutely with severe headache, confusion, lethargy, altered sensorium , and neck rigidity. Typically disease evolves over 1-2 weeks, a course longer than that of bacterial meningitis. Paresis of cranial nerves is frequent finding and involvement of cerebral arteries may produce focal ischaemia. This case study elaborates the treatment line and observations made in a 19 year old male patient who presented with Generalized Tonic and Clonic Seizures episodes and significant sensory deficit. Patient was admitted in ICU for further evaluation and management. Initially on admission, all emergency medicines were administered to stabilize the patient. Then MRI brain was done, suggestive of multiple conglomerate round to oval lesions in bilateral cerebellar hemispheres and left frontal region with extensive leptomeningeal enhancement s/o infective etiology like tuberculosis, with chest X-ray revealing multiple small opacities in bilateral lung fields. Along with allopathy treatment, Ayurvedic management in the form of Abhyantara and Bahya chikitsa, were successively done allied with physiotherapy. Yogabastikrama with Sandnyasthapana gana as Kashaya and Kalka was done intervened by Anuvasana basti. Succeedingly, Marsha nasya were also incorporated with periodical neurological, hematological and biochemical assessment. On discharge, Brahmi ghrita were advised inclusive of Anti-tubercular drugs & physiotherapy.