Petersen Hannes, Patel Mitesh, Ingason Einar F, Einarsson Einar J, Haraldsson Ásgeir, Fransson Per-Anders
Department of Otorhinolaryngology, Landspitali University Hospital, Reykjavik, Iceland; Faculty of Medicine, University of Iceland, Reykjavík, Iceland.
Department of Clinical Sciences, Lund University, Lund, Sweden; Department of Clinical Neuroscience, Neuro-Otology Department, Imperial College London, London, United Kingdom.
PLoS One. 2014 Nov 18;9(11):e112016. doi: 10.1371/journal.pone.0112016. eCollection 2014.
Bacterial meningitis in childhood is associated with cognitive deficiencies, sensorimotor impairments and motor dysfunction later in life. However, the long-term effects on postural control is largely unknown, e.g., whether meningitis subjects as adults fully can utilize visual information and adaptation to enhance stability. Thirty-six subjects (20 women, mean age 19.3 years) treated in childhood or adolescence for bacterial meningitis, and 25 controls (13 women, mean age 25.1 years) performed posturography with eyes open and closed under unperturbed and perturbed standing. The meningitis subjects were screened for subjective vertigo symptoms using a questionnaire, clinically tested with headshake and head thrust test, as well as their hearing was evaluated. Meningitis subjects were significantly more unstable than controls during unperturbed (p≤0.014) and perturbed standing, though while perturbed only with eyes open in anteroposterior direction (p = 0.034) whereas in lateral direction both with eyes open and closed (p<0.001). Meningitis subjects had poorer adaption ability to balance perturbations especially with eyes open, and they frequently reported symptoms of unsteadiness (88% of the subjects) and dizziness (81%), which was found significantly correlated to objectively decreased stability. Out of the 36 subjects only 3 had unilateral hearing impairment. Hence, survivors of childhood bacterial meningitis may suffer long-term disorders affecting postural control, and would greatly benefit if these common late effects became generally known so treatments can be developed and applied.
儿童期细菌性脑膜炎与日后生活中的认知缺陷、感觉运动障碍和运动功能障碍有关。然而,其对姿势控制的长期影响在很大程度上尚不清楚,例如,成年后患脑膜炎的受试者是否能够充分利用视觉信息和适应能力来增强稳定性。36名在儿童期或青少年期接受过细菌性脑膜炎治疗的受试者(20名女性,平均年龄19.3岁)和25名对照组受试者(13名女性,平均年龄25.1岁)在睁眼和闭眼状态下,于无干扰和有干扰站立时进行了姿势描记。使用问卷对脑膜炎受试者进行主观眩晕症状筛查,通过摇头和头脉冲试验进行临床测试,并评估他们的听力。在无干扰(p≤0.014)和有干扰站立时,脑膜炎受试者比对照组明显更不稳定,不过在有干扰时,仅在前后方向睁眼时(p = 0.034),而在侧向方向睁眼和闭眼时均如此(p<0.001)。脑膜炎受试者对平衡干扰的适应能力较差,尤其是在睁眼时,他们经常报告不稳定症状(88%的受试者)和头晕(81%),发现这些症状与客观上稳定性下降显著相关。在36名受试者中,只有3人有单侧听力障碍。因此,儿童期细菌性脑膜炎幸存者可能会遭受影响姿势控制的长期障碍,如果这些常见的晚期影响广为人知,从而能够开发和应用相应治疗方法,他们将受益匪浅。