We present a case of a 45-year-old patient with miliary tuberculosis (MI), whose initial clinical symptomatology was uncertain. A few weeks after the beginning of chemotherapy, and in the face a Jacksonian crisis, cerebral tuberculomas were detected with CAT. The interesting thing in this case is to highlight that the diagnosis of MT anatomopathologic after pulmonary biopsy with mini-thoracotomy and that the cerebral complication could be classified within the so-called "paradoxical worsening" as it has been documented in the literature.