The significance of seizures and other predictive factors during the acute illness for the long-term outcome after bacterial meningitis.
BACKGROUND
Seizures are important neurological complications of bacterial meningitis, but no information about its epidemiology and the outcomes of seizures after community-acquired bacterial meningitis (CABM) in an adult population have been reported.


OBJECTIVE
To determine the frequency, clinical relevance, subtypes of seizures during the acute phase of bacterial meningitis, and the long-term outcomes of seizure complicating adult CABM.


METHODS
In this 12-year retrospective study, 117 adult patients were identified with culture-proven CABM. A comparison was made between the clinical data of the patients with and without seizures during hospitalization.


RESULTS
Thirty-one patients had seizures during CABM, accounting for 27% (31/117) of the episodes. The time interval between the onset of bacterial meningitis and the seizures was 1-21 days (mean, 4 days). Furthermore, 80% (25/31) of the episodes occurred within 24 h of presentation. Ten patients who had seizures progressed to status epilepticus. At follow-up after completing treatment, 10 patients completely recovered and were seizure-free, 19 died of meningitis during the acute stage and the other two progressed to chronic epilepsy.


CONCLUSIONS
A log-rank test demonstrated that the long-term outcome of adult CABM with acute seizures produced worse outcomes than for those who had no seizures, though no difference was noted between focal and generalized seizures. None of our patients without seizures in the acute phase of bacterial meningitis developed late seizures during the follow-up periods. Poor outcome in this study may attribute to neurological complications such as seizure, hydrocephalus, infection itself, or a combination of complications.
Wang
Kuo-Wei
KW
Department of Neurosurgery, Chang Gung Memorial Hospital-Kaohsiung, Taiwan.
Chang
Wen-Neng
WN
Chang
Hsueh-Wen
HW
Chuang
Yao-Chung
YC
Tsai
Nai-Wen
NW
Wang
Hung-Chen
HC
Lu
Cheng-Hsien
CH
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications* / Q000382:microbiology; D008875:Middle Aged; D012189:Retrospective Studies; D012640:Seizures / Q000453:epidemiology* / Q000209:etiology* / Q000382:microbiology