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Early symptomatic and late seizures in Kosovar children with bacterial meningitis

Sadie A Namani1, Ernest Kuchar, Remzie Koci

  • 1Clinic of Infectious Diseases, University Clinical Centre of Kosovo, Prishtina, Kosovo. sadie_namani@yahoo.com

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|May 21, 2011
PubMed

Insights

Seizures before hospital admission significantly predict adverse outcomes in children with bacterial meningitis. Late seizures indicate acute neurological complications and a high risk of poor prognosis.

Area of Science:

  • Pediatrics
  • Neurology
  • Infectious Diseases

Background:

  • Bacterial meningitis mortality has decreased, but neurological sequelae persist.
  • Seizures are a critical factor influencing outcomes in pediatric meningitis.
  • Understanding seizure predictors is vital for managing meningitis complications.

Purpose of the Study:

  • To investigate seizures as predictors of death and neurological sequelae in pediatric bacterial meningitis.
  • To analyze the occurrence and timing of seizures in relation to meningitis outcomes.
  • To identify risk factors associated with adverse outcomes, including late seizures.

Main Methods:

  • Retrospective chart review of 277 children (0-16 years) treated for bacterial meningitis.
  • Analysis of seizure occurrence: prior to admission, after admission, and late seizures (>24h).
  • Correlation of seizure patterns with adverse outcomes and neurological complications.

Main Results:

  • Seizures occurred prior to admission in 22% and after admission in 21% of patients.
  • Late seizures (>24h) were diagnosed in 9% of children.
  • Seizures prior to admission and late seizures significantly increased the risk of adverse outcomes (RR 8.17 and 6.78, p<0.0001).
  • Late seizures were associated with acute neurological complications like subdural effusion and hydrocephalus.

Conclusions:

  • Pre-admission seizures are strong predictors of adverse outcomes in pediatric bacterial meningitis.
  • Secondary epilepsy risk (9%) was observed only in children with acute structural neurological complications.
  • Early identification and management of seizures are crucial for improving meningitis outcomes.
Abstract

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