Clinico epidemiological, neurocognitive profile and prognostic factors in tuberculous meningitis

We report the clinical, biochemical, microbiological, imaging, and neurocognitive characteristics of TBM patients and factors affecting their outcomes. Eighty-eight patients were assessed at baseline and followed up using MRC, MBI, and mRS scales . Cognitive impairment was evaluated using the ICMR-NCTB Battery in Grade 1 and Grade 2 TBM patients. Common symptoms included fever (93.2%), headache (90.9%), and altered mentation (63.6%). CSF analysis showed significant changes in leukocyte count, protein, and glucose levels. Basal exudates and hydrocephalus were common neuroimaging findings. Neurocognitive profiles improved significantly in Grade 1 and 2 TBM patients at 3 months follow up with results showing greater improvement in attention and executive function. For individual neurocognitive tests, patients with Grade 1 TBM demonstrated superior performance in the Trail Making Test Black and White test especially Part A, with a significant increase in the proportion of patients achieving normal results, rising from 28.3% at baseline to 55.0% at follow-up ( P = 0.01). CRP levels correlated positively with neurocognitive impairment. In-hospital mortality was 4.3%. Total leukocyte count, lactate dehydrogenase, creatine phosphokinase, erythrocyte sedimentation rate, and C-reactive protein may serve as useful prognostic biomarkers for assessing disease severity and predicting cognitive and functional recovery in TBM.