Ungureanu et al.
Meningitis, meningoencephalitis and encephalitis in Bern: an observational study of 258 patients
BMC Neurol. 2021; 21:474. doi:10.1186/s12883-021-02502-3

A monocentric, observational study has been conducted to assess the frequency, clinical presentation and long-term outcome (with a focus on sleep disorders and wakefulness) of encephalitis, meningoencephalitis, and meningitis treated in the Inselspital University Hospital Bern, Switzerland.

From a total of 463 screened patient medical records, 258 patients during a 34-month period were included in the retrospective analysis of the study.

Of these patients, 46 (18%) were treated for encephalitis, 109 (42%) for nonbacterial meningoencephalitis, 70 (27%) for nonbacterial meningitis and 33 (13%) for bacterial meningoencephalitis/meningitis. Overall, the most frequent causes were of infectious origin (57%); in 5%, an immune-mediated cause was found; and 36% remained without a known cause.

TBE virus infection was the most frequently detected cause of meningoencephalitis or meningitis (65/258 cases, 25%). Fifty-eight patients (89%) presented with meningoencephalitis (including nine cases of meningoencephalomyelitis and meningoencephalomyeloradiculitis), six patients (9%) had meningitis and one patient (2%) had encephalitis.

The medium time from the onset of signs and symptoms until hospital admission was 5.5 days in encephalitis, 4 days for nonbacterial meningitis and 2 days in bacterial meningoencephalitis/meningitis.

A telephone follow-up interview took place at a median of 16 months after hospital discharge. Only 50% of patients with encephalitis and 81% of nonbacterial meningoencephalitis were able to restart work or studies to the same extent as before the acute illness. Persisting neurological manifestations were reported by 56% of patients. Excessive daytime sleepiness and/or fatigue were frequently reported in the follow-up, and 42% reported sleep-wake disorders, cognitive impairment and memory deficits, headache and epileptic seizures.

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