Chronic Meningitis

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Chronic Meningitis
Chronic Meningitis
Video: Chronic Meningitis
Video: 43. Chronic meningitis 2023, February
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Chronic meningitis

Chronic meningitis (inflammation of the membranes of the brain and / or spinal cord) is generally rather rare, develops gradually and can have a wide variety of causes. It can arise, for example, as a result of a purulent infection near the brain or spinal cord, such as an otitis media, which does not heal properly despite taking antibiotics. Other causes are tuberculosis, fungal infections, Borrelia, syphilis, sarcoid as well as chemical substances, many other pathogens and diseases (eg HIV / AIDS) etc.

Patients with weakened immune systems / immunosuppressed patients are particularly at risk. Malignant (malignant) tumors that spread to the meninges can also lead to the symptoms of chronic meningitis, but they do not cause inflammation in the strict sense.

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What are the symptoms?

Chronic meningitis is shown by the following symptoms:

  • Headache (persistent headache),
  • possibly stiff neck,
  • Fatigue, fever,
  • Personality changes (sleepiness, disorientation, memory loss, etc.),
  • neurological deficits, sensory disorders, paralysis of nerves (e.g. impaired vision and / or hearing, numbness of arms or legs) and much more,
  • Vomiting, seizures, epileptic fits.

The chronic or recurring inflammation can cause serious damage to the nervous system. The symptoms are - depending on the cause - sometimes different and appear at different rates. They can persist chronically or recur.

How is the diagnosis made?

The doctor orients himself to the health condition of the person concerned. Symptoms give clues.

  • Medical history & symptoms. To determine the cause of the symptoms, many factors are essential, including travel / stays (various risk or endemic areas - see travel medicine), contact with tuberculosis sufferers, diet (e.g. raw meat consumption, unpasteurized dairy products), sexual contact, etc. Possible other diseases are also clarified.
  • Physical examination is also essential to clarify the symptoms, as well as to diagnose any other underlying disease. Various examinations may be necessary for this. X-rays, CT scans, MRIs and a biopsy of the meninges (meninges and spinal cords) may be performed.
  • Lumbar puncture. The diagnosis includes a lumbar puncture, in which cerebrospinal fluid (CSF) is removed from the spinal canal. The CSF samples can then be examined for signs of inflammation and pathogens, eg PCR, cell count.
  • Further investigations. Depending on the symptoms, physical examination and sample result, further examinations may be necessary (e.g. further CSF or blood tests). Laboratory tests such as leukocytes, glucose, protein content, TPHA, blood count, differential blood count, ESR, electrolytes, liver, kidney values, etc. are carried out.

How is the treatment carried out?

The therapy is based on the severity of the infection, the pathogen and accompanying or underlying diseases. Depending on the cause, antibiotics, antifungal drugs (anti-fungal agents) or glucocorticoids are used for this.

Further information on the diagnosis and treatment of certain diseases or infections can be found at

  • tuberculosis
  • Lyme disease
  • syphilis
  • HIV & AIDS

Whom can I ask?

A suspected chronic meningitis is usually clarified and treated as an inpatient in hospital. In the event of severe pain, high fever, changes in consciousness, neurological deficits, sensory disorders, stiff neck or loss of consciousness, etc., notify the emergency doctor immediately ! Lumbar punctures are done in the hospital. The contact person for (mild) headaches can also be a general practitioner or a neurologist.

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