Helbok Raimund, Broessner Gregor, Pfausler Bettina, Schmutzhard Erich
Dept. of Neurology, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
J Neurol. 2009 Feb;256(2):168-75. doi: 10.1007/s00415-009-0122-0. Epub 2009 Feb 17.
Chronic meningitis is an inflammation of the meninges with subacute onset and persisting cerebrospinal fluid (CSF) abnormalities lasting for at least one month. Several non-infectious and infectious etiologies are known to be causative. The wide range of different etiologies renders the approach to patients with this syndrome particularly difficult. There is no standardized diagnostic procedure, thus, taking an in depth history combined with a complete physical examination is mandatory in every patient.This review aims to present the current knowledge on etiology, neurological course of disease, diagnostic and therapeutic management steps of patients presenting with clinical signs and symptoms of chronic meningitis and meningoencephalitis. Still, the etiology of one third of patients remains unclear, reflecting the diagnostic challenge of this syndrome for each physician or neurologist, respectively. However, most patients with idiopathic chronic meningitis have a relatively good outcome.
慢性脑膜炎是一种脑膜炎症,起病亚急性,脑脊液(CSF)异常持续至少一个月。已知多种非感染性和感染性病因可导致该病。病因种类繁多,使得处理患有该综合征的患者尤为困难。目前尚无标准化的诊断程序,因此,对每位患者进行深入的病史采集并结合全面的体格检查是必不可少的。本综述旨在介绍目前关于慢性脑膜炎和脑膜脑炎临床症状和体征患者的病因、神经系统病程、诊断和治疗管理步骤的知识。然而,仍有三分之一患者的病因不明,这分别反映了该综合征对每位内科医生或神经科医生的诊断挑战。不过,大多数特发性慢性脑膜炎患者的预后相对较好。