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P. (1977) Acute necrotic myelopathy with pulmonary tuberculosis. Brain, 100, 2 2 3 - 2 3 8 ILLINGWORTH, R. s. (1956) Miliary and meningeal tuberculosis - difficulties in diagnosis. Lancet, ii, 646-649 KALiSH, s. B . , RADIN, R. C , LEVITZ, D . , Z A I F F , C. R. and SHAIR, J . p. (1983) The enzyme-linked immunosorbent assay method for IgG antibody to purified protein derivative in cerebrospinal fluid of patients with tuberculous meningitis. Annals of Internal Medicine, 99, 6 3 0 - 6 3 3 KENNEDY, D .

C , BHATTIA, A . L . , S E L K O N , J . B . , SUBBAIAH, T. V. and LANCASTER, M . C. (1960) A comparison of the virulence in guinea pigs of South Indian and British tubercle bacilli. Tubercle, 4 1 , 1 - 2 2 NAVARRO, I. M . , PERALTA, V. Η . I . , L E O N , J . Α . , VARRELLA, E . A . and CABRERA, J . M. (1981) Tuberculous optochiasmatic arachnoiditis. Neurology, 9, 6 5 4 - 6 6 0 N E W M A N , p. , CUMMING, w . J . κ. and FOSTER, J. B. (1980) Hydrocephalus and tuberculous meningitis in adults. Journal of Neurology, Neurosurgery and Psychiatry, 4 3 , 188-190 O'TOOLE, R.

In practice it is important to estimate levels of liver enzymes, bilirubin and alkaline phosphatase before commencing treatment, and initially every 3 - 4 days, or more often if liver enzyme levels begin to rise. Should this happen it is reasonable to repeat the tests daily. In the majority of cases, the levels reach a plateau and then begin to fall within a few days. If the rise persists, isoniazid and rifampicin should be stopped, pyrazinamide and streptomycin continued, and ethambutol added.

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