Meningitis refers to an infection of the meninges, a part of the central nervous system. It can spread to involve other parts of the nervous system, such as the brain and spinal cord, and can be quite devastating. Long-term complications of the disease can occur, unfortunately even with appropriate treatment at time of presentation. Bacterial types of meningitis tend to cause more damage than viral types and tend to cause most of the complications.
Hydrocephalus
This is a condition characterized by a buildup of fluid inside the skull that can increase intracranial pressures. This increased pressure exerts itself on the brain, and affected patients have symptoms such as incontinence, uncoordinated gait, altered mental status and impaired judgment. There are a few different types of hydrocephalus. Meningitis can result in the development of communicating hydrocephalus. Inflammatory debris from the infection can obstruct a structure known as the arachnoid granulations; their function is to absorb cerebrospinal fluid in order to maintain a proper fluid balance. When they are obstructed, the fluid builds up and hydrocephalus results.
Neurologic Complications
These complications occur as a result of damage to the nervous system structures. Any one of the cranial nerves can be affected, resulting in disruption of eye movement, tongue motion and sensation, facial muscle movement, chewing, facial sensation, blindness and impaired swallow reflexes. The brain can get involved, resulting in seizures, weakness, paralysis and disruptions in sensory perception.
Behavioral Abnormalities
When the behavior center in the brain is affected, abnormalities can result. This is especially harsh in young patients with meningitis, as developing brains suffer damage from which some don't fully recover. Examples include speech delay, learning disabilities and altered behavior. Intelligence deficits with permanently lowered IQ are also seen. Often these deficits fail to correct over a lifetime and result in a permanently developmentally delayed person.
References
- "Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 7th Edition;" Mandell; 2009
- "Rosen's Emergency Medicine, 7th Edition;" Marx; 2009
- New England Journal of Medicine. "Neurologic complications in children with enterovirus 71 infection." Huang CC, Liu CC, Chang YC, et al. Sep 23 1999;341(13):936-42
