Epilepsy Research (2012) 99, 107—111 journal homepage: www.elsevier.com/locate/epilepsyres Natural course of epilepsy concomitant with CNS tuberculomas Abdulaziz AlSemari a,* , Salah Baz a , Fahad Alrabiah b , Thamer Al-Khairallah a , Najeeb Qadi a , Abid Kareem a , Abdulrahman A. Alrajhi b a Neurology Section, Department of Neurosciences, King Faisal Specialist Hospital & Research Centre, MBC 76, P.O. Box 3354, Riyadh 11211, Saudi Arabia b Infectious Disease Section, Department of Internal Medicine, King Faisal Specialist Hospital & Research Centre, MBC 46, P.O. Box 3354, Riyadh 11211, Saudi Arabia Received 26 April 2011; received in revised form 25 October 2011; accepted 30 October 2011 Available online 26 November 2011 KEYWORDS Epilepsy; Seizure; Tuberculoma; Anti-epileptic; Antituberculous therapy Summary 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 pre- sented 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. © 2011 Elsevier B.V. All rights reserved. Introduction Tuberculosis (TB) is a disease caused by bacteria belonging to the mycobacterium tuberculosis complex. The cause of * Corresponding author. E-mail address: alsemari@kfshrc.edu.sa (A. AlSemari). infectious tuberculosis was under debate until Robert Koch’s discovery of the tubercle bacillus in 1882. The tubercles usually rupture into the subarachnoid space. Then military tubercles form around the outer sheaths of the small cere- bral blood vessels. The centre of the accumulation becomes caseous, and then thickens and dries. A thick capsule may form around these lesions and form what is recognized as a tuberculoma. CNS tuberculomas have been known to 0920-1211/$ — see front matter © 2011 Elsevier B.V. All rights reserved. doi:10.1016/j.eplepsyres.2011.10.032