Cognitive and executive function 12 years after childhood bacterial meningitis: effect of acute neurologic complications and age of onset.

OBJECTIVES This study investigated long-term neurobehavioral outcome from childhood bacterial meningitis, with particular focus on the influence of acute neurologic complications and age at illness. METHODS This prospective, longitudinal study compared survivors of childhood bacterial meningitis (n = 109) with grade- and gender-matched controls (n = 96) selected from the target children's schools 12 years post-illness, in order to identify residual deficits in intellectual, academic, and executive ability. RESULTS Results showed that at 12 years post-illness, children with a history of meningitis were at greater risk of impairment in each of these domains. However, development was shown to keep pace with that exhibited by healthy controls, suggesting no deterioration in function with time since illness. While prediagnosis symptom duration and acute neurologic complications were not predictors of 12-year outcome, meningitis before 12 months of age was significantly related to poorer performance on tasks requiring language and executive skills. CONCLUSIONS These findings suggest that while the overall impact of meningitis may be relatively general and mild, younger age at illness is predictive of neurobehavioral outcome. There was no evidence of progressive deterioration postmeningitis, with comparison of results from 7 to 12 years post-illness demonstrating significant "catch-up" in aspects of executive function.