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Predictors of long term neurological outcome in bacterial meningitis

Pratibha Singhi1, Arun Bansal, P Geeta

  • 1Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Indian Journal of Pediatrics
|May 4, 2007
PubMed

Insights

About one-third of children surviving acute bacterial meningitis (ABM) experience long-term neurological and developmental issues. Predictors like low Glasgow Coma Scale score and cranial nerve palsy at admission indicate higher risk for these sequelae.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Developmental Pediatrics

Background:

  • Acute bacterial meningitis (ABM) is a serious infection in children that can lead to significant long-term health problems.
  • Understanding the predictors of these sequelae is crucial for timely intervention and management.

Purpose of the Study:

  • To investigate the long-term neurological and developmental outcomes in children following ABM.
  • To identify clinical and laboratory predictors associated with the development of sequelae.

Main Methods:

  • Retrospective review of clinical and demographic data from medical records of children treated for ABM.
  • Minimum 12-month follow-up including neurological, developmental, and hearing assessments.
  • Statistical analysis to compare children with and without sequelae, identifying significant predictors.

Main Results:

  • 40% of children (32/80) developed sequelae, with 30% experiencing major impairments.
  • Global developmental delay was observed in 34.5% of patients.
  • Seizures, cranial nerve palsy, abnormal reflexes, Glasgow Coma Scale (GCS) score < 8, positive CSF culture, and abnormal head imaging (CT/ultrasound) were associated with sequelae.

Conclusions:

  • Neurological, audiological sequelae, and global developmental delay are common in ABM survivors.
  • Admission indicators such as GCS score < 8, cranial nerve palsy, infarct, or hydrocephalus on imaging can identify children at high risk for long-term complications, necessitating extended follow-up and rehabilitation.
Abstract

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