Verlauf und Prognose der FSME

Abstract

Sixty-three patients with tick-borne encephalitis were studied for sequelae up to 5 years after the acute illness (median: 12 months, range: 1-44 months). Patients were examined clinically, by neuropsychological testing and by electroencephalography. The clinical presentation during the acute stage was as follows: Meningitis (M,n = 12), Meningoencephalitis (Me,n = 27), Meningoencephalomyelitis (My,n = 15), and Meningoencephaloradiculitis (R,n = 9). A total of 59 patients reported a neurasthenic syndrome after discharge, which correlated with the severity of the acute illness. Twenty patients were not able to work because of reduced stress tolerance, fatigue or an elevated emotional sensitivity, which lasted for 3 months at most. In some patients hypacusis (n = 7), severe dysarthria and dysphagia (n = 4) remained essentially unimproved for years following the acute illness. While in 8/9 patients with radiculitis paresis of the extremities improved well over months to years, improvement was quite limited in all patients with myelitis. In 41/55 patients, investigations by electroencephalography revealed normal findings even within months after acute illness. Persistent cognitive deficits were present only in 7/11 patients with a severe course of disease.

Akute disseminierte Enzephalomyelitis nach aktiver Immunisierung gegen Frühsommermeningoenzephalitis

“…850 Fälle) nicht etwa bei beruflich exponierten Personen (z. B. Forstangestellten), sondern bei Freizeitlern beobachten lässt [4,6,6,9].…”

“…94% der Patienten sollen im Anschluss an das Akutstadium der Erkrankung ein pseudoneurasthenisches Syndrom haben, welches bei der rein meningitischen Form nach 1-2 Monaten abklingt, aber bei der meningoenzephalitischen Form bis zu einem Vierteljahr zur Krankschreibung führen kann [5]. Gefürchtet ist die Myelitis, weil häufig schwer verlaufend und mit schlecht remittierenden Tetraparesen und Atemlähmung einhergehend [4,5]. Im Bereich der Hirnnerven sind bleibende neurologische Ausfälle Hörminderung, Dysarthrie und Dysphagie.…”

“…Im Bereich der Hirnnerven sind bleibende neurologische Ausfälle Hörminderung, Dysarthrie und Dysphagie. Die Letalität der FSME wird mit 1-2% angegeben [4,5,10].…”

Mild cognitive impairment after viral meningitis in adults

“…There have been only a few studies that followed up patients with aseptic meningitis regarding children as well as adults [1,12,17,18,20], though aseptic meningitis -in most cases of various viral aetiology -is much more frequent [27]. To our knowledge, cognitive deficits after presumed viral meningitis in adults have been investigated with standardised neuropsychological methods only in a few of these studies [12,18]. The aim of our study, therefore, was to examine the long-term outcome after presumed viral meningitis in adults.…”

“…s Key words viral meningitis · infectious disease · outcome measurement · psychometric deficit Remarkably, outcome research after acute CNS-infections were focused on bacterial meningitis [6,21,25,28] and viral encephalitis [8,10,12,13,18,23,29,30] during recent decades. There have been only a few studies that followed up patients with aseptic meningitis regarding children as well as adults [1,12,17,18,20], though aseptic meningitis -in most cases of various viral aetiology -is much more frequent [27].…”