Abstract :
Tuberculosis of the nervous system constitutes about 10% of total cases and is more common in developing countries like India. Varied clinical presentations, ranging from meningoencephalitis, tuberculoma, multiple cranial palsies to myelo-radiculitis, are noted. Here we highlight central sleep apnoea as an acute presentation, which is unusual in a neurological setting. Here, we present a 49-year old male, presented with acute onset of excessive daytime sleepiness for two weeks. Clinically he had no focal deficits. MRI brain plain and contrast showed multiple conglomerate ring-enhancing lesions with vasculitic infarcts consistent with tuberculosis. CSF analysis was normal apart from slightly elevated protein. He was initiated on steroids and anti-tuberculous therapy. Hypersomnia as an acute and solitary neurological presentation secondary to subacute infections is a rarity. Apart from vascular insults, infections like tuberculosis needed to be considered as one of the differentials. Early evaluation helps in prevention of associated complications and improve the quality of life.
Keyword :
Central sleep apnoea, Excessive Daytime Sleepiness, Tuberculosis