In simple words: Tuberculosis (TB) can affect the nervous system, including the brain, spinal cord, and the membranes covering them. This can cause inflammation and different neurological problems like headaches, fever, confusion, weakness, and seizures.

Tuberculosis of the nervous system encompasses tuberculous meningitis, intracranial tuberculoma, and spinal arachnoiditis. Tuberculous meningitis typically presents as a subacute to chronic meningitis syndrome, often with a prodrome of malaise, fever, and headache progressing to altered mental status and focal neurological signs. Intracranial tuberculomas are focal lesions, often ring-enhancing on imaging, and can cause seizures or focal neurological deficits. Spinal arachnoiditis involves inflammation of the spinal cord and nerve roots, leading to pain, sensory disturbances, and motor weakness.

Example 1: A patient presents with fever, headache, stiff neck, and altered mental status. CSF analysis reveals low glucose, elevated protein, and lymphocytic pleocytosis. Imaging shows meningeal enhancement. The patient is diagnosed with tuberculous meningitis (A17)., A patient with a history of pulmonary tuberculosis develops seizures. MRI reveals a ring-enhancing lesion in the brain consistent with a tuberculoma. The patient is diagnosed with CNS tuberculosis (A17)., A patient experiences progressive back pain, lower extremity weakness, and sensory loss. MRI shows inflammation and compression of the spinal cord. A biopsy confirms Mycobacterium tuberculosis infection. The patient is diagnosed with spinal arachnoiditis as a manifestation of CNS tuberculosis (A17).

Documentation should include clinical findings (e.g., fever, headache, neurological deficits), CSF analysis results, imaging findings, and microbiological confirmation if available. The specific type of CNS-TB (meningitis, tuberculoma, or arachnoiditis) should be clearly documented.