Clinical Characteristics And Prognosis Of Convulsion Associated With Acute Purulent Meningitis Of Children

Objective: To investigate the clinical features, related factors and prognosis of convulsion associated acute purulent meningitis in children.Methods: 1. Select the clinical data of children purulent meningitis cases admitted in Children’s Hospital Affiliated to Soochow University from July 2010 to August 2014. According to the convulsions appearance in acute phase of purulent meningitis, 99 patients were divided into with convulsion group(42 cases) and without convulsion group(57 cases). To analysis the incidence, duration, frequency, seizure type, etc of the acute convulsions. 2. Made a compare of clinical data between the patients with or without acute phase convulsions, to investigate the related factors of the convulsion in acute phase of children purulent meningitis. 3. Following up the prognosis of the purulent meningitis children, 64 children obtained complete information, 25 cases with convulsion and 39 cases without convulsion. Made a compare of the prognosis between the two groups; then divide the 25 cases into favorable and adverse outcome groups according to the prognosis, then made a compare between the two groups to investigate the related factors of adverse outcome of the purulent meningitis children who experienced convulsion in acute phase.Results: 1.Among the 99 cases of purulent meningitis children, 42 cases had convulsion in acute phase, the incidence was 42.4%; 32 having only one seizure type while the other 10 having two seizure types, there were 30(71.4%) having generalized seizures, 19(45.2%) having focal seizures, 3(7.1%) having focal seizures evolving to generalized seizure, 7(16.7%) having generalized and focal seizures; Time interval between the onset of bacterial meningitis and that of seizures was 1 to 12 days(mean 3.83 days); Of the 42 cases, 6(14.3%) had experienced status convulsion, 14(33.3%) had afebrile convulsions during the illness. 2. The age, hospitalization time, disturbed consciousness, serum sodium <135mmol/L, CSF protein>1g/L, CSF immunoglobulin G, cleared pathogens, abnormal neuroimaging findings, sequelae, prognosis had significant difference(P<0.05) between the groups with and without convulsions in acute phase of purulent meningitis. We concluded that the age<2 years, disturbed consciousness, serum sodium<135mmol/L were the related factors of convulsions in acute purulent meningitis after multivariate Logistic regression analysis. 3. The age, focal seizure, seizure frequently, status convulsion had significant difference(P <0.05) between the patients who had convulsions in purulent meningitis acute phase with favorable outcome or adverse outcome. After multivariate Logistic regression analysis, seizure frequently in acute phase was a related factor to adverse outcome.Conclusions:1.The most common type of convulsions in acute phase of purulent meningitis children was generalized seizures in our study.2. Age<2 years, disturbed consciousness, serum sodium<135mmol/L were the related factors of convulsions in acute purulent meningitis.3. Whether or not with convulsion in acute purulent meningitis was suggestive to the prognosis, especially the children who had frequent seizures in acute phase were more likely to had an adverse outcome.