A study of clinical profile of cranial nerve palsy in meningitis and its significance from a tertiary care centre in South India

Abstract

Cranial nerve involvement in meningitis is not uncommon and readily treatable if addressed at the earliest. Hospital admissions due to meningitis is quite common in developing countries like India.Here we present a study about clinical profile of meningitis patients with cranial nerve involvement and its significance in day to day practice. This study is conducted from a tertiary care centre of South India. The present study can aid in differentiation of types of meningitis and arrive at proper diagnosis especially in resource limited settings. Materials and Methods: The study was conducted for a period of three consecutive years with a sample size of 150 patients. It is a cross sectional descriptive study where in data was collected and analysed among various variables necessary. Patients with symptoms of meningitis and involvement of either of twelve cranial nerves were taken into consideration. Necessary investigations and examinations were done. Results: Cranial nerve involvement was most commonly seen in tubercular meningitis as compared to other types of meningitis. 6 th cranial nerve was most commonly involved followed by 3 rd , 2 nd , 8 th and 7 th respectively. Fever and neck stiffness were seen in considerable number of patients of meningitis with cranial nerve palsy and especially in less than 45 years of age. Conclusion: Tubercular meningitis should be the first differential diagnosis in a patient presenting with symptoms of meningitis (or fever) with cranial nerve palsy. Presence of only papilledema without cranial nerve palsy warrants to exclude other causes.