Increased frequency of central nervous system infections has been implicated in the high incidence of epilepsy in developing countries. Of all the CNS infections that occur, bacterial meningitis is endemic in many countries and several epidemics have also been reported in these regions. Epilepsy could possibly be a long-term sequel of bacterial meningitis. Streptococcus pneumoniae is the main etiological agent in meningitis responsible for the probability of developing seizure or epilepsy as a later symptom.
Sometimes, epilepsy is associated with the symptoms and causes of meningitis. However, the incidence and occurrence of epilepsy as a result of the symptoms depends largely on two factors – the virus causing meningitis and the actual occurrence of bacterial meningitis. In the developed countries, the predicted estimates of occurrences of bacterial meningitis are around 0.6–4out of every 100,000 adults annually. This number could even go up to 10x greater in other lesser developed parts of the globe. In developed countries, the predicted estimates of occurrences of bacterial meningitis in kids are higher – 1.5 for every 100,000 kids. In developing ones, the number is even higher at 20 for every 100,000 kids annually. In fact, the S. pneumoniae, the H. influenzae Type B and the Neisseria meningitides are accountable for more than 80% meningitis cases. In the new-born age group, the common pathogens are the bacilli that are gram-negative such as the Klebsiella species or the Escherichia coli.
There are multiple risk factors either directly or indirectly related to manifestations of epilepsy. Extremes of age are directly associated with the consequences and prognosis. The development of neurological complications could be a direct result of the following or a combination of them – susceptibility to the host, portal of entry, and the number, virulence and organism type of bacteria. Patients who are on immunosuppressive drugs, or who suffer from chronic liver disorders, or who are diabetics or alcoholics or those with HIV, malignancy or congenital or acquired immune deficiency disease are at increased risk of meningitis and its sequel as compare to the general population. Streptococcus pneumoniae is the most common cause of meningitis related to the neurological sequel as compared to the other organisms.
Prevention of Epilepsy
There are numerous intermediaries which contribute to the heightened penetrability of the brain-blood barrier and which result in the migration of leukocytes across the same barrier when bacterial meningitis hits. There are some quite promising adjuvant therapeutic strategies for bacterial meningitis and bacterial meningitis symptoms which could be helpful in targeting pathways which are involved in neuronal injuries initiation and down-regulating the mediators. Of note: epilepsy is avoidable to quite an extent by effectively implementing vaccination programs which fight against the most common meningitis-causing pathogens.
- Neurologic abnormalities detected soon after the acute illness do not always persist. These deficits usually resolve slowly over the course of weeks to months after the acute illness.
- A sensorineural hearing loss could transpire more regularly than other neurologic deficits after meningitis happens or hits, but it is associated with a very less risk of epilepsy.
- In most cases, when epilepsy trails and happens after meningitis attacks, it takes place within 5 years of it.