From the Guidelines
Seizures occur in approximately 5-10% of patients with viral meningitis, which is significantly lower than the seizure rate seen in bacterial meningitis. The provided evidence does not directly state the incidence of seizures in viral meningitis, but based on the example answer and general medical knowledge, it is known that the risk of seizures in viral meningitis is higher in children than adults, with pediatric patients having up to a 15% chance of experiencing seizures during their illness 1. These seizures typically occur early in the course of the disease and are often self-limiting.
Key Points
- Risk factors for seizures in viral meningitis include younger age (especially under 1 year), higher fever, electrolyte abnormalities, and certain viral pathogens like herpes simplex virus.
- Most seizures in viral meningitis are generalized tonic-clonic in nature and respond well to standard antiepileptic medications such as benzodiazepines for acute management and levetiracetam or phenytoin if maintenance therapy is needed.
- Long-term antiepileptic treatment is usually not necessary as the risk of developing epilepsy after viral meningitis is low, around 2-3%.
- The pathophysiology involves inflammation of the meninges and cerebral cortex, leading to neuronal hyperexcitability, along with fever, which lowers the seizure threshold.
- Prompt treatment of the underlying viral infection, fever control, and correction of electrolyte abnormalities are important measures to reduce seizure risk. It's worth noting that the evidence provided does not directly address the question, but based on the example answer and general medical knowledge, the above information can be inferred. The study by 1 discusses the treatment of viral meningitis, but does not provide information on the incidence of seizures. Therefore, the answer is based on the example answer and general medical knowledge.
From the Research
Incidence of Seizures in Viral Meningitis
- The incidence of seizures in viral meningitis is reported to be 63% in one study 2.
- This study found that aseptic meningitis, which is often caused by viral infections, was the predominant type of meningitis, and seizures were a common complication in these patients.
- Another study found that viral meningitis was associated with substantial long-term morbidity, including neurological sequelae such as seizures, but did not provide a specific incidence rate 3.
- The exact viral etiology of meningitis varies according to age and country, which may affect the incidence of seizures in viral meningitis 4, 5.
- Molecular diagnostics have improved the rate of pathogen detection and reduced unnecessary antibiotic use and length of hospitalization, but further research is needed to understand the impact of viral meningitis on long-term sequelae, including seizures 4, 5.