Chronic And Recurrent Meningitis

Question 1

Inflammation of the meningitis (pia,arachnoid,dura)

• fatal
• characterised b neurologic symptoms exist for more than 4 week associated with inflammatory response in the cerebrospinal fluid (WBC >5/ul)

Answer 1

Chronic and recurrent meningitis

1. Meningeal infections
2. malignancy
3. autoimmune
4. chemical meningitis
5. parameningeal infections

Question 2

CSF is produced by

Answer 2

Choroi plexus of the cerebral ventricles

Reabsorbed by : superior sagital sinus.

Spread from the subarachnoid space into brain parenchyma may occur via arachnoid cuffs: Virchow robin spaces.

Question 3

Basal meningitis

Answer 3

Multiple cranial neuropathies

1. Decreased vision (CN II)
2. Facial weakness (CN VII)
3. Decreased hearing (CN VIII)
4. Diplopoda (CN III,IV, and VI)
5. Sensory Motor abnormality oropharynx ( CN IX, X, and XII)
6. Decreased olfaction (CN I)
7. Decreased facial sensation (CN V)

Question 4

Spinal meningitis

Answer 4

• radicular pain, sensory loss, motor weakness and urinary or fecal inconvenience
• pachymeningitis: chronic inflammation causes clumping of the lower nerve roots and thickening of the meningitis

Meninggeal inflammation: encircle and damage the cord resulting in myelopathy

Question 5

Two clinical forms of chronic meningitis

Answer 5

1. Symptoms are chronic and persistent
2. Recurrent, discrete episodes of illness- all symptoms, signs, and CSF parameters of meningeal inflammaion

Possible etiologies: mollaret’s meningitis:due to HSV type 2