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Seizures associated with meningitis.

N M Rosenberg1, K Meert, D Marino

  • 1Department of Pediatrics, Children's Hospital of Michigan, Detroit 48201.

Pediatric Emergency Care
|April 1, 1992
PubMed
Summary

Bacterial meningitis can present solely as a seizure, especially in patients pretreated with antibiotics. Prompt lumbar puncture is crucial for early diagnosis and better outcomes in such cases.

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Area of Science:

  • Neurology
  • Infectious Diseases

Background:

  • Bacterial meningitis is a serious infection affecting the central nervous system.
  • Seizures are a known complication of meningitis, but their presentation can vary.
  • Antibiotic pretreatment may alter the typical clinical manifestations of meningitis.

Purpose of the Study:

  • To investigate the clinical presentation of bacterial meningitis, particularly seizures.
  • To determine the impact of prior antibiotic use on seizure presentation in meningitis patients.
  • To assess the outcomes of patients with meningitis-associated seizures.

Main Methods:

  • Retrospective review of 187 patient records with bacterial meningitis.
  • Analysis of seizure presentation, including pretreatment with antibiotics.

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  • Comparison of clinical findings and outcomes between different patient groups.

    • Main Results:

    • Seizures were observed in 13% of bacterial meningitis patients (25/187).
    • Of patients with presenting seizures, 28% (7/25) had prior antibiotic exposure.
    • Pretreated patients with seizures showed fewer additional symptoms compared to untreated patients (P < 0.01).
    • Hospitalized patients who developed seizures had poorer outcomes.

    Conclusions:

    • Bacterial meningitis may present with isolated seizures in patients taking antibiotics.
    • Antibiotic pretreatment can mask other meningitis symptoms, leading to delayed diagnosis.
    • Lumbar puncture is essential for all patients on antibiotics who experience seizures to rule out meningitis.