Neurological sequelae of bacterial meningitis

Abstract

Objectives: We reported on occurrence and impact of neurological sequelae after bacterial meningitis.

Methods: We reviewed occurrence of neurological sequelae in children and adults after pneumococcal and meningococcal meningitis.

Results: Most frequently reported sequelae are focal neurological deficits, hearing loss, cognitive impairment and epilepsy. Adults with pneumococcal meningitis have the highest risk of developing focal neurological deficits, which are most commonly caused by cerebral infarction, but can also be due to cerebritis, subdural empyema, cerebral abscess or intracerebral bleeding. Focal deficits may improve during clinical course and even after discharge, but a proportion of patients will have persisting focal neurological deficits that often interfere in patient's daily life. Hearing loss occurs in a high proportion of patients with pneumococcal meningitis and has been associated with co-existing otitis. Children and adults recovering from bacterial meningitis without apparent neurological deficits are at risk for long-term cognitive deficits. Early identification of neurological sequelae is important for children to prevent additional developmental delay, and for adults to achieve successful return in society after the disease.

Conclusions: Neurological sequelae occur in a substantial amount of patients following bacterial meningitis. Most frequently reported sequelae are focal neurological deficits, hearing loss, cognitive impairment and epilepsy.

Keywords: Cognitive impairment; Epilepsy; Focal neurological deficits; Hearing loss; Meningitis; Sequelae.