Audiovestibular and neuropsychological outcome of adults who had recovered from childhood bacterial meningitis.
A sample of 22 subjects was studied from a population of adults who had suffered from bacterial meningitis in childhood. Audiovestibular, oculomotor and neuropsychological investigations were performed and quality of life was assessed. An age-matched control group of 20 subjects was recruited. In the meningitis group, nine subjects had abnormal pure tone audiograms. One was previously undiagnosed and a progression was found in four. There was an overrepresentation of subclinical vestibular pathology (6 out of 9 (67%)) in this group. Audiovestibular test results showed a peripheral pattern and oculomotor tests were normal. The quality of life scores of those with hearing loss were significantly higher than those in the control group. Neuropsychological tests of brain dysfunction were abnormal in six out of 22 (27%) who had recovered from meningitis. The prevalence of such dysfunctions was not related to audiovestibular disorder. The quality of life scores of those with brain dysfunctions were similar to those of the control group. The findings of reduced auditory memory and tone level perception in four out of 22 (18%), suggest that lesions of central auditory pathways may follow from bacterial meningitis. The results support the idea that inner ear damage is the major cause of hearing loss after bacterial meningitis. Despite the absence of brainstem involvement, central nervous system lesions with disturbed auditory processing and language functions can be of significance. The high frequency of discrete brain dysfunctions indicate that a thorough neuropsychological investigation is required after bacterial meningitis.
Department of Otorhinolaryngology, Orebro Medical Center Hospital, Sweden. svante.hugosson@orebroll.se
S
S
Hugosson
E
E
Carlsson
E
E
Borg
L O
LO
Brorson
G
G
Langeroth
P
P
Olcén
D000328:Adult; D001299:Audiometry; D001925:Brain Damage, Chronic / Q000175:diagnosis; D016022:Case-Control Studies; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis; D006801:Humans; D008297:Male; D008583:Meningitis, Haemophilus / Q000453:epidemiology / Q000503:physiopathology / Q000534:rehabilitation*; D008585:Meningitis, Meningococcal / Q000453:epidemiology / Q000503:physiopathology / Q000534:rehabilitation*; D009483:Neuropsychological Tests; D009801:Oculomotor Muscles / Q000503:physiopathology; D011788:Quality of Life; D013997:Time Factors; D014724:Vestibular Function Tests