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Chronic and recurrent meningitis

L Ginsberg1, D Kidd

  • 1Department of Neurology, Royal Free Hospital, London, UK. lionel.ginsberg@royalfree.nhs.uk

Practical Neurology
|November 19, 2008
PubMed

Insights

Chronic meningitis, lasting over four weeks, often lacks a clear cause. This review details its features, causes, and offers an investigation and treatment algorithm.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Immunology

Background:

  • Chronic meningitis is defined by symptoms persisting over four weeks.
  • Causes are diverse, including infections, cancers, and inflammatory conditions.
  • A significant portion of chronic meningitis cases remain undiagnosed.

Purpose of the Study:

  • To review the clinical features and etiological spectrum of chronic meningitis.
  • To present an evidence-based algorithm for the investigation and management of chronic meningitis.

Main Methods:

  • Comprehensive literature review of chronic and recurrent meningitis.
  • Analysis of diagnostic approaches and treatment strategies.

Main Results:

  • Infective causes include bacterial, tuberculous, syphilitic, Lyme, and fungal meningitis.
  • Non-infective causes encompass sarcoidosis, Behçet's disease, vasculitis, and drug-induced reactions.
  • Diagnosis requires extensive investigation, with no cause identified in up to one-third of cases.

Conclusions:

  • Chronic meningitis necessitates a thorough diagnostic workup.
  • An organized approach is crucial for identifying the underlying cause and guiding treatment.
  • Effective management relies on accurate etiological diagnosis.

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