CLINICAL MANIFESTIONS B Meningeal Irritation Stage(1-2 week) 1. More serious TB toxic symptoms 2. Intracranial hypertension: severe headache, irritation, projectile vomiting, seizures Bulging of anterior fontanelle, widening of cranial sutures in infant 3. Meningeal Irritation nuchal rigidity, hypertonia Kernig sign or Brudzinski sign 4. Cranial nerve abnormalities: 3.6.7 5. Some children have no evidence of meningeal irritation but may have signs of encephalitis: disorientation, abnormal movements and speech impairment 1313 CLINICAL MANIFESTIONS B. Meningeal Irritation Stage (1-2 week) 1. More serious TB toxic symptoms 2. Intracranial hypertension: severe headache, irritation, projectile vomiting, seizures; Bulging of anterior fontanelle, widening of cranial sutures in infant 3. Meningeal Irritation : nuchal rigidity, hypertonia Kernig sign or Brudzinski sign 4. Cranial nerve abnormalities: 3, 6, 7 5. Some children have no evidence of meningeal irritation but may have signs of encephalitis: disorientation, abnormal movements and speech impairment