FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 323:1651-1657 December 13, 1990 Number 24 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

BACKGROUND. Although the mortality rate among children with bacterial meningitis has decreased dramatically in recent decades, some patients are left with neurologic sequelae. It has not been clearly established which features of the acute illness predict the chronic neurologic sequelae, including late seizures or epilepsy. METHODS. We followed 185 infants and children prospectively during and after acute bacterial meningitis. The mean duration of follow-up was 8.9 years (range, 0.1 to 15.5). During the first six years standard neurologic examinations were performed; telephone interviews were conducted thereafter. RESULTS. One month after meningitis, 69 children (37 percent) had neurologic abnormalities. Many of these signs resolved within a year, leaving only 26 children (14 percent) with persistent deficits: 18 (10 percent) had only sensorineural hearing loss, and 8 (4 percent) had multiple neurologic deficits. Thirteen children (7 percent) had one or more late seizures not associated with fever. The presence of persistent neurologic deficits indicative of cerebral injury was the only independent predictor of late afebrile seizures (P less than 0.001). CONCLUSIONS. After bacterial meningitis only children with permanent neurologic deficits are at high risk for epilepsy. Those with normal examinations after the acute illness have an excellent change of escaping serious neurologic sequelae, including epilepsy.

Source Information

Department of Pediatrics, Washington University School of Medicine, St. Louis, MO.

This article has been cited by other articles:

• Ispahani, P, Slack, R C B, Donald, F E, Weston, V C, Rutter, N (2004). Twenty year surveillance of invasive pneumococcal disease in Nottingham: serogroups responsible and implications for immunisation. Arch. Dis. Child. 89: 757-762 [Abstract] [Full Text]  
• Chang, C.-J., Chang, W.-N., Huang, L.-T., Chang, Y.-C., Huang, S.-C., Hung, P.-L., Ho, H.-H., Chang, C.-S., Wang, K.-W., Cheng, B.-C., Lui, C.-C., Chang, H.-W., Lu, C.-H. (2003). Cerebral infarction in perinatal and childhood bacterial meningitis. QJM 96: 755-762 [Abstract] [Full Text]  
• Hodgson, A., Smith, T., Gagneux, S., Akumah, I., Adjuik, M., Pluschke, G., Binka, F., Genton, B. (2001). Survival and sequelae of meningococcal meningitis in Ghana. Int J Epidemiol 30: 1440-1446 [Abstract] [Full Text]  
• Dodge, P. R., Scaer, M., Holmes, S. J., Pomeroy, S. L., Feigin, R. D. (2001). Psychometric Testing in Bacterial Meningitis: Results of a Long-Term Prospective Study of Infants and Children Treated Between 1973 and 1977. J Child Neurol 16: 854-857 [Abstract]  
• Lieu, T. A., Ray, G. T., Black, S. B., Butler, J. C., Klein, J. O., Breiman, R. F., Miller, M. A., Shinefield, H. R. (2000). Projected Cost-effectiveness of Pneumococcal Conjugate Vaccination of Healthy Infants and Young Children. JAMA 283: 1460-1468 [Abstract] [Full Text]  
• van Deuren, M., Brandtzaeg, P., van der Meer, J. W. M. (2000). Update on Meningococcal Disease with Emphasis on Pathogenesis and Clinical Management. Clin. Microbiol. Rev. 13: 144-166 [Abstract] [Full Text]  
• Taylor, H. G., Schatschneider, C., Watters, G. V., Mills, E. L., Gold, R., MacDonald, N., Michaels, R. H. (1998). Acute-Phase Neurologic Complications of Haemophilus Influenzae Type b Meningitis: Association With Developmental Problems at School Age. J Child Neurol 13: 113-119 [Abstract]  
• Mclntyre, P. B., Berkey, C. S., King, S. M., Schaad, U. B., Kilpi, T., Kanra, G. Y., Perez, C. M. O. (1997). Dexamethasone as Adjunctive Therapy in Bacterial Meningitis: A Meta-analysis of Randomized Clinical Trials Since 1988. JAMA 278: 925-931 [Abstract]  
• McCormick, M. C. (1997). The Outcomes of Very Low Birth Weight Infants: Are We Asking the Right Questions?. Pediatrics 99: 869-869 [Full Text]  
• Pikis, A., Kavaliotis, J., Tsikoulas, J., Andrianopoulos, P., Venzon, D., Manios, S. (1996). Long-Term Sequelae of Pneumococcal Meningitis in Children. CLIN PEDIATR 35: 72-78 [Abstract]  
• D'Angio, C. T., Froehlke, R. G., Plank, G. A., Meehan, D. J., Aguilar, C. M., Lande, M. B., Hugar, L. (1995). Long-term Outcome of Haemophilus influenzae Meningitis in Navajo Indian Children. Arch Pediatr Adolesc Med 149: 1001-1008 [Abstract]  
• Kallio, M. J. T., Kilpi, T., Anttila, M., Peltola, H. (1994). The Effect of a Recent Previous Visit to a Physician on Outcome After Childhood Bacterial Meningitis. JAMA 272: 787-791 [Abstract]  
• Kelly, D. P., Kelly, B. J., Jones, M. L., Moulton, N. J., Verhulst, S. J., Bell, S. A. (1993). Attention Deficits in Children and Adolescents With Hearing Loss: A Survey. Arch Pediatr Adolesc Med 147: 737-741 [Abstract]  
• Letson, C. W., Gellin, B. G., Bulkow, L. R., Parks, D. J., Ward, J. I. (1992). Severity and Frequency of Sequelae of Bacterial Meningitis in Alaska Native Infants: Correlation With a Scoring System for Severity of Sequelae. Arch Pediatr Adolesc Med 146: 560-566 [Abstract]  
• Marks, M. I. (1991). Bacterial Meningitis An Update. CLIN PEDIATR 30: 673-675 [Abstract]  
• Mertsola, J., Kennedy, W. A., Waagner, D., Saez-Llorens, X., Olsen, K., Hansen, E. J., McCracken, G. H. Jr (1991). Endotoxin Concentrations in Cerebrospinal Fluid Correlate With Clinical Severity and Neurologic Outcome of Haemophilus influenzae Type B Meningitis. Arch Pediatr Adolesc Med 145: 1099-1103 [Abstract]  
• Joynt, R. J. (1991). Neurology. JAMA 265: 3134-3135 [Abstract]  
• McMillan, J. A., Oski, F. A. (1991). Pediatrics. JAMA 265: 3156-3158 [Abstract]