Abstract
Study design:
A case report of spinal cord dysfunction following meningococcal meningitis.
Objectives:
To describe a rare complication of meningococcal meningitis.
Setting:
Spinal Unit, Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, Pakistan.
Methods:
A young healthy male developed meningococcal meningitis followed by acute onset low thoracic flaccid paraplegia with complete motor and sensory loss and sphincter disturbance. He responded well to antibiotics but was not investigated for causes of paraplegia. While at home in a rural area, he developed pressure ulcers, anemia and depression. Magnetic resonance imaging of the whole spine and computed tomography scan of the brain performed after 4 and 10 weeks were normal.
Results:
The patient had a comprehensive rehabilitation at our institute. Recovery was complicated by ossification in the right thigh, which responded well to radiotherapy. At 1-year follow-up, the motor deficit and neurogenic bladder and bowel persisted and the patient remained wheelchair dependent for mobility.
Conclusion:
Several mechanisms have been proposed to explain spinal cord damage after meningitis. These include spinal cord infarction; autoimmune-mediated inflammatory myelopathy and direct infection of the cord. Most probable cause of spinal cord dysfunction in this case was thoracic myelopathy.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Duke T, Curtis N, Fuller DG . The management of bacterial meningitis in children. Expert Opin Pharmacother 2003; 4: 1227–1240.
Tunkle AR, Scheld WM . Acute bacterial meningitis. Lancet 1995; 346: 1675–1680.
Bhojo AK, Akhter N, Bakshi R, Wasay M . Thoracic myelopathy complicating acute meningococcal meningitis: MRI findings. Case reports. Am J Med Sci 2002; 323: 263–265.
Kastenbauer S, Winkler F, Fesl G, Schiel X, Ostermann H, Yousry TA et al. Acute severe spinal cord dysfunction in bacterial meningitis in adults. Arch Neurol 2001; 58: 806–810.
Khan J, Altafullah I, Ishaq M . Spinal cord dysfunction complicating meningococcal meningitis. Postgrad Med J 1990; 66: 302–303.
Kastenbauer S, Winkler F, Fesl G, Schiel X, Ostermann H, Tarek A et al. Acute severe spinal cord dysfunction in bacterial meningitis in adults: MRI findings suggest extensive myelitis. Arch Neurol 2001; 58: 806–810.
Choudhary N, Kumar N, Ahlawat R, Jain K, Rizvi Y, Agarwal G et al. Meningococcal meningitis with myelopathy: case report and review of literature. Cent Eur J Med 2007; 2: 122–127.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Rathore, M., Gill, Z., Malik, A. et al. Acute flaccid paraplegia: a rare complication of meningococcal meningitis. Spinal Cord 46, 314–316 (2008). https://doi.org/10.1038/sj.sc.3102120
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.sc.3102120
