Cognitive outcome in adults with moderate disability after pneumococcal meningitis.
OBJECTIVE
To assess cognitive outcome and quality of life in patients with moderate disability after bacterial meningitis as compared to patients with good recovery.


METHODS
Neuropsychological evaluation was performed in 40 adults after pneumococcal meningitis; 20 patients with moderate disability at discharge on the glasgow outcome scale (GOS score 4) and 20 with good recovery (GOS score 5).


RESULTS
Patients with GOS score 4 had similar test results as compared to patients with GOS score 5 for the neuropsychological domains 'intelligence', 'memory' and 'attention and executive functioning'. Patients with GOS score 4 showed less cognitive slowness than patients with GOS score 5. In a linear regression analysis cognitive speed was related to current intelligence, years of education and time since meningitis. Overall performance on the speed composite score correlated significantly with time since meningitis (-0.62; P<0.001). Therefore, difference between both groups may have been related to a longer time between meningitis and testing for GOS four patients (29 vs. 12 months; P<0.001).


CONCLUSIONS
Patients with moderate disability after bacterial meningitis are not at higher risk for neuropsychological abnormalities than patients with good recovery. In addition, cognitive slowness after bacterial meningitis may be reversible in time.
Weisfelt
Martijn
M
Department of Neurology, Academic Medical Center, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands. m.weisfelt@amc.uva.nl
van de Beek
Diederik
D
Hoogman
Martine
M
Hardeman
Clara
C
de Gans
Jan
J
Schmand
Ben
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D003072:Cognition Disorders / Q000209:etiology* / Q000382:microbiology / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D023261:Glasgow Outcome Scale; D006801:Humans; D008297:Male; D008586:Meningitis, Pneumococcal / Q000150:complications* / Q000382:microbiology / Q000503:physiopathology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011788:Quality of Life