The sequelae of tuberculous meningitis

Abstract

Examinations were carried out 31 to 14 years after the onset of the original illness on 65 patients who survived one or more attacks of tuberculous meningitis. The physical, social, emotional and intellectual status of these patients has been assessed. Physical defects, e.g. hemiplegia, weakness or incoordination of a limb, epilepsy and deafness were found in approximately one-third of the patients; significant intracranial calcification was found in 21 patients; abnormal audiograms were obtained in 26, and although hearing loss was clinically significant in few of these, obviously deaf children encountered considerable educational difficulties; abnormal EEG records were obtained in 47 patients. Intelligence was average or above average in 40, dull normal in 13, borderline defective in 6 and mentally defective in 6 patients. Level of intelligence was not related directly to the severity of the original illness or to age, but a greater risk of intellectual impairment was apparent in the younger patients because the disease was usually more severe in this age-group. Normal education was possible in 35 patients, 9 attended special schools for physically or intellectually handicapped pupils and 2 were in mental deficiency institutions. Of the older patients 15 were in full-time employment and 2 were unemployable as a result of their handicaps. 38 patients were emotionally well adapted, 20 were mildly maladapted and 9 severely maladapted. Thus approximately 43 % of the survivors of tuberculous meningitis were either mildly or severely maladjusted, compared with the generally accepted figure of 10% for the population as a whole.