Tuberculous encephalopathy mimicking limbic encephalitis and large intraparenchymal mass: A case report

Abstract

We report a 17-year-old gentleman presented with acute encephalopathy and neuropsychiatric disturbances. Contrast-enhanced CT and MRI brain revealed bilateral enhancing grey matter lesions involving both basal ganglia with perilesional oedema. The peculiarity of the lesions raising confusions whereby limbic encephalitis and intracranial masses were initially given consideration hence causing a delay in treatment. Tuberculous encephalopathy has different imaging appearances depending on the stage of maturity which will be further discussed here. Definitive treatment for this patient comprises of daily 10-months dose of anti-tuberculous drugs with prompt neurosurgical intervention if required. However, these should be delivered at a timely fashion to improve the outcome for both survival and neurological sequelae.