Bacterial meningitis and epilepsy.

The high incidence and prevalence of epilepsy in developing countries has partly been attributed to an increased frequency of central nervous system (CNS) infections. Of the CNS infections, bacterial meningitis is endemic in many countries and several epidemics have also been reported in these regions. Unprovoked seizures and epilepsy (recurrent unprovoked seizures) can be long-term sequelae of bacterial meningitis. The probability of developing an unprovoked seizure or epilepsy varies according to the etiologic agent responsible for meningitis and this probability appears to be higher for Streptococcus pneumoniae. The risk factors for late unprovoked seizures/epilepsy include early seizures during the acute phase of meningitis and persistent neurological deficits other than sensorineural hearing loss. The majority of unprovoked seizures occur within 5 years of the meningitis episode and tend to be recurrent. The burden of epilepsy associated with bacterial meningitis depends upon the incidence of the latter and hence is to some extent preventable. Implementing vaccination programs against the three most important meningeal pathogens can reduce the incidence of bacterial meningitis. In developed countries, a decline in the incidence of bacterial meningitis has been accomplished with the implementation of vaccination programs.