Long-term sequelae after viral meningitis and meningoencephalitis are frequent, even in mildly affected patients, a prospective observational study

Janine Schwitter; Mattia Branca; Antonela Bicvic; Lena S Abbuehl; Franziska Suter-Riniker; Stephen L Leib; Anelia Dietmann

doi:10.3389/fneur.2024.1411860

Long-term sequelae after viral meningitis and meningoencephalitis are frequent, even in mildly affected patients, a prospective observational study

Front Neurol. 2024 Jul 17:15:1411860. doi: 10.3389/fneur.2024.1411860. eCollection 2024.

Authors

Janine Schwitter¹, Mattia Branca², Antonela Bicvic¹, Lena S Abbuehl¹, Franziska Suter-Riniker³, Stephen L Leib³, Anelia Dietmann¹

Affiliations

¹ Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
² CTU Bern, University of Bern, Bern, Switzerland.
³ Institute for Infectious Diseases, University of Bern, Bern, Switzerland.

Abstract

Introduction: An increasing number of studies demonstrate that viral meningitis and meningoencephalitis, even those with a mild course of meningitis, can result in residual sequelae.

Methods: We aimed to investigate the long-term outcome in both viral meningitis and meningoencephalitis/encephalitis patients and impact of long-term sequelae on patients' social and professional daily lives in a prospective observational study with a follow-up period of 20 months.

Results: A total of 50 patients (12% encephalitis, 58% meningoencephalitis and 30% meningitis) and 21 control persons participated in the study. The most common cause was the tick-borne encephalitis (TBE) virus. The most important persistent signs and symptoms after 2 years were subjective cognitive impairment (36%), fatigue and/or excessive daytime sleepiness (31%), disturbed nighttime sleep (31%) and headaches (13%), as well as feeling more rapidly exhausted after cognitive effort (53%). Independent of disease severity in the acute phase, almost one third of patients still reported mildly impaired social and/or professional life due to the long-term sequelae, with scores in the health status assessment still significantly lower compared to healthy controls.

Discussion: Regardless of the severity of the acute illness and despite constant improvement within 2 years, 67% of patients still had persistent signs and symptoms, but these were only relevant to everyday social or professional life in about 30% of these patients.

Keywords: long-term sequalae; meningitis; meningoencephalitis; outcome; tick-borne encephalitis; viral encephalitis.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. AD has been personally funded by academic research grants from the Bangerter Rhyner Stiftung and University Bern.