Post meningitis symptoms

Question

I was diagnosed with a severe viral meningitis in Feb 2011. I am in my mid 40's (Female). By April I was much better, back home, walking 2km a day, vision good, feeling healthy.  But in June I still get pins and needles in my hands, often at night but some days the tingling stays in my hands until lunchtime or later. 

My vision almost completely left me during the illness with the optical nerves being affected by the swelling around the brain, and it was restored. But now I am unable to read small print on the back of bottles.

My question is, can viral meningitis cause long term nerve damage that results in tingling/pins & needles in the hands and some minor vision impact?

VM_2 · Answer

I believe I suffered from viral meningitis. The symptoms in comparison to the average person is exactly the same, except mine seemed to go on for about 6 months. My GP refused to recommend me for a spinal tap, he concluded it was a virus and I experienced migraines at the same time. When I further explained to Dr's about the unsteady gait, brain fog, uncontrollable brain fluid leaks from my nose, pressure in my brain beyond belief.. they surmised it was sinuses and treated with me with antibiotics - which obviously did not make any difference whatsoever. After a few weeks of the initial symptoms, I also began experiencing numbness throughout several parts of my body. It began with severe burning sensations (like hot steam) and then the glove effect took over on these areas. Dr's were so focused on it being MS, that over the months that followed, I had been only tested for MS related tests and scans. I even had a nerve test where about a 20cm needle is poked through the areas of numbness to track the nerve's reaction  - so there's nothing to hide. They found little to no reaction. After several months of tests, I wasn't given any treatment. Was prescribed paracetamol and co-codemol, and was basically told if incontinence occurred or I got worse, I should come back to hospital immediately. 

Because of being off work for several weeks at a time without a proper diagnosis, I lost my job. I have a first class degree, but have never felt more incompetent with all of the symptoms I experienced during this time. As for the pain during the initial months, it was the worse thing I could possibly imagine. The after-effects went on for another year were I experienced various other things...seemed like I had chicken pox - I had this when I was young, so Dr's felt it couldn't be it...and then had internal bleeding for a couple weeks. Their investigations covered bowel cancer or something related. 

After about 2 years since it began, most things have gone back to normal except for the numbness. Those areas in my body remain numb, and I also experience tingling and tinnitus intermittently. I feel my memory is effected too. Sometimes certain words are harder to recall...I've lost all confidence to work in my field again and I haven't been in a long-term job ever since then.

sky777 · Answer

Thank you doctor. My meningitis was in place for 8 weeks, diagnosed after 5 weeks after a lumbar puncture was done and the fluid tested. the first hospital sent me home after 2 weeks as I had been ill for 3 weeks and they thought if I rested at home recovery was imminent. However I did not get better and was hospitalised a week later again and after the 5th week of being ill the spinal tap/lumber puncture was done. I had several MRIs and CAT scans and so I can check that MS was excluded, but I think if I had MS my symptoms would be more severe. I just have tingling in my hands and sometimes my vision is not perfect like it used to be. Thank you again for your response. I will discuss further with my doctor and the Neurologist.

DrSharma · Answer

Hi there. The prognosis for viral meningitis is usually excellent with most resolving in 7 to 10 days. It is usually self limiting except in neonates. Concomitant encephalitis can add potential for adverse outcomes. Other poor outcome indicators are pericarditis and hepatitis. Your multiple symptoms are suggestive of MS and need to be excluded. The other differential diagnosis of MS, which can be ruled out with blood tests, CSF analysis, CT, MRI scan, EMG can help rule out other diagnosis. these are complicated migraines, tumor or other cord compression like spinal stenosis, stroke, herpes simplex encephalitis, HTLV -1 associated myelopathy, myasthenia gravis, diabetes, lyme disease, SLE, sjogren’s syndrome, sarcoidosis, paraneoplastic syndromes, guillain barre syndrome, parkinson’s disease, cervical spondylosis etc. MS is a chronic demyelinating disorder where the disease phase is characterized by active phase and remissions. It has multiple symptoms and signs and is a diagnosis of exclusion. The symptoms of multiple sclerosis are loss of balance, muscle spasms, numbness in any area, problems with walking and coordination, tremors in one or more arms and legs. Bowel and bladder symptoms include frequency of micturition, urine leakage, eye symptoms like double vision uncontrollable rapid eye movements, facial pain, painful muscle spasms, tingling, burning in arms or legs, depression, dizziness, hearing loss, fatigue etc. The treatment is essentially limited to symptomatic therapy so the course of action would not change much whether MS has been diagnosed or not. Apart from clinical neurological examination, MRI shows MS as paler areas of demyelination, two different episodes of demyelination separated by one month in at least two different brain locations. Spinal tap is done and CSF electrophoresis reveals oligoclonal bands suggestive of immune activity, which is suggestive but not diagnostic of MS. Demyelinating neurons, transmit nerve signals slower than non-demyelinated ones and can be detected with EP tests. These are visual evoked potentials, brain stem auditory evoked response, and somatosensory evoked potential. Slower nerve responses in any one of these is not confirmatory of MS but can be used to complement diagnosis along with a neurological examination, medical history and an MRI in addition, a spinal tap. Therefore, it would be prudent to consult your neurologist with these concerns. Hope this helps. Take care.

sky777 · Answer

Bump - Hoping for responses from a neurologist, just about the possibility of long term nerve damage that results in pins and needles.tingling in the hands. I'm wondering if this could happen from the inflammation of the meninges or from the lumber puncture.