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Why Does Meningitis Cause Hearing Loss

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What Is Meningitis What Is Encephalitis

What is a sensorineural hearing loss?

Infections and other disorders affecting the brain and spinal cord can activate the immune system, which leads to inflammation. These diseases, and the resulting inflammation, can produce a wide range of symptoms, including fever, headache, seizures, and changes in behavior or confusion. In extreme cases, these can cause brain damage, stroke, or even death.

Inflammation of the meninges, the membranes that surround the brain and spinal cord, is called meningitis inflammation of the brain itself is called encephalitis. Myelitis refers to inflammation of the spinal cord. When both the brain and the spinal cord are involved, the condition is called encephalomyelitis.

Causes And Risk Factors

Meningitis is inflammation of the protective membranes of the brain and spinal cord called the meninges. It usually results from an infection, but in rare cases is associated with a non-infectious cause such as brain surgery or lupus.

Hearing loss is almost always associated with bacterial meningitis. According to a 2010 review in Pediatrics, hearing loss can affect anywhere from 30% to 50% of people with pneumococcal meningitis, 10% to 30% of those with Haemophilus influenzae type B meningitis, and 5% to 25% of those with meningococcal meningitis.

Studies show hearing loss rarely occurs with viral meningitis. Fungal and parasitic meningitis are even less likely causes.

Other factors that increase the risk of hearing loss caused by meningitis include:

As a general rule, anyone who has had bacterial meningitis should have a hearing test as soon as possible. All cases of hearing loss are different, however, and you’ll generally need repeat tests to get an accurate evaluation of your hearing.

How Is Meningitis Diagnosed

Bacterial meningitis can be very serious. So if you see symptoms or think that your child could have meningitis, it’s important to see the doctor right away.

If meningitis is suspected, the doctor will order tests, probably including a lumbar puncture to collect a sample of spinal fluid. This test will show any signs of and whether the infection is due to a virus or bacteria.

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Recent Research Into Preventing Limb Loss From Meningitis

There has been some encouraging research in recent years into the mechanism of the runaway blood clotting that is typical in severe meningococcal disease. Scientists in one study found that, when meningococcal bacteria bind to the lining of blood vessels, a molecule called ADAM10 becomes active and prevents the bodys natural ability to stop uncontrollable clotting. It is hoped that this discovery will lead to new therapies.

However, for the time being, the best way to combat bacterial meningitis is rapid referral, diagnosis and treatment with IV antibiotics . The right antibiotics will root out and kill the harmful bacteria, and prevent this bacteria from multiplying and releasing toxins. If this is done in a timely fashion, the risk of limb loss is greatly reduced.

Once a diagnosis is made, treatment tends to take place quickly. Worryingly however, delays are often at the diagnostic stage. A report in 2018 undertaken by the Meningitis Research Foundation found that, in 134 accounts taken from parents whose children displayed symptoms of meningitis, 103 were sent home with reassurances that it was a milder condition. In 23 of these cases, the child died, whilst others suffered serious injuries including amputations.

Why Does Meningitis Cause Photophobia

Causes of hearing loss

Since meningitis is an inflammation of brain and spinal membranes, it should be no surprise that it can interfere with neurological processesone of which may result in . In fact, one of the earliest warning signs of meningitis is this aversion or reaction to light, often co-occurring with nausea, stiff neck and headache.

Furthermore, an intense meningitis-related headache can often resemble migraine or other headache disorders, which are separately known to cause or exacerbate light sensitivity. In fact, 95% of post-infection patients in one study had severe, bilateral headachesthe majority of which were described as “abrupt onset” and the worst they had ever experienced. Although it is unclear if these symptoms could be directly classified as a primary headache disorder like migraine, they commonly displayed migraine features like photophobia.3

Lastly, many people experience temporary eyesight difficulties due to optic nerve swelling after meningitis. With this condition, patients might continue to experience photophobia as a lingering effect.

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Meningitis Is A Major Cause Of Hearing Loss In Children

Children who have had meningitis are five times more likely to have a significant hearing impairment than other children, while 2.4% of survivors had bilateral hearing loss that required a cochlear implant. In general, a third of children who survive meningitis will be left with devastating long-term conditions.One-in-three youngsters treated for the disease will suffer mental health problems, epilepsy or learning difficulties, the study found. One-in-five children will have anxiety or behavioural disorders, while young survivors are five times more likely to have speech and communication problems. The disease also affected long and short-term memory, with some children left with a borderline low IQ, the researchers suggest.

How Long Might Post

Furthermore, patients who have either bacterial or viral meningitis often have a reduced quality of life, especially in their younger years.4 Light sensitivity and headache symptoms are also independently linked to poorer life outcomes as well as emotional symptoms. This ultimately stresses the importance of proper diagnosis and treatment early on in the lifecycle of the infection in order to avoid these consequences.

References:

1Amarilyo G, Alper A, Ben-Tov A, Grisaru-Soen G. Diagnostic accuracy of clinical symptoms and signs in children with meningitis. Pediatr Emerg Care. 2011 Mar 27:196-9. doi: 10.1097/PEC.0b013e31820d6543.

2Patriquin G, Hatchette J, Forward K. Clinical presentation of patients with aseptic meningitis, factors influencing treatment and hospitalization, and consequences of enterovirus cerebrospinal fluid polymerase chain reaction testing. Can J Infect Dis Med Microbiol. 2012 23:e1-5.

3Lamonte M, Silberstein SD, Marcelis JF. Headache associated with aseptic meningitis. Headache. 1995 Oct 35:520-6.

4Neufeld MY, Treves TA, Chistik V, Korczyn AD. Postmeningitis headache. Headache. 1999 Feb 39:132-4.

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What Can You Do

Normal hearing happens because nerve cells in the cochlea send sound signals along the auditory nerve to the brain. If the meningitis causes hearing loss, hearing normally doesnt come back because the soft tissues inside the cochlea start to turn to bone, and the nerve cells start to die.

In these cases, hearing aids usually arent strong enough to help so the typical treatment is a cochlear implant.2

A cochlear implant reproduces sound in ears that dont work for certain reasons, including meningitis-related ossification. Ossification means that the nerve cells will die over time if they dont receive any electrical signals like the ones the hair cells sent. A cochlear implant can stimulate these nerve cells with electrical pulses, keeping them alive, and sends a signal along the auditory nerve in a way thats similar to normal hearing.

It does this with whats called an electrode array, a thin and flexible piece of silicone thats inserted into the cochlea. The electrode array sits in the cochlea, so every time it sends a tiny electrical pulse this pulse is sent through the living nerve cells so they are heard by your brain.

Whens the best time to receive a cochlear implant? As with almost all types of hearing loss, sooner is better. It doesnt matter if youre a 2 year old or 102 a shorter time between hearing loss and cochlear implantation can lead to better hearing with the cochlear implant.

What Causes Meningitis And Encephalitis

3 Different Types of Hearing Loss | Ear Problems

Infectious causes of meningitis and encephalitis include bacteria, viruses, fungi, and parasites. For some individuals, environmental exposure , recent travel, or an immunocompromised state are important risk factors. There are also non-infectious causes such as autoimmune/rheumatological diseases and certain medications.

Meningitis

Bacterial meningitis is a rare but potentially fatal disease. Several types of bacteria can first cause an upper respiratory tract infection and then travel through the bloodstream to the brain. The disease can also occur when certain bacteria invade the meninges directly. Bacterial meningitis can cause stroke, hearing loss, and permanent brain damage.

Other forms of bacterial meningitis include Listeria monocytogenes meningitis Escherichia coli meningitis, which is most common in elderly adults and newborns and may be transmitted to a baby through the birth canal and Mycobacterium tuberculosis meningitis, a rare disease that occurs when the bacterium that causes tuberculosis attacks the meninges.

Fungal infections can affect the brain. The most common form of fungal meningitis is caused by the fungus cryptococcus neoformans . Cryptococcal meningitis mostly occurs in immunocompromised individuals such as those with AIDS but can also occur in healthy people. Some of these cases can be slow to develop and smolder for weeks. Although treatable, fungal meningitis often recurs in nearly half of affected persons.

Encephalitis

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How Meningitis Related Hearing Loss Can Be Treated

You may go through the following treatment methods for hearing loss caused due to meningitis.

  • Visit hearing specialist for hearing evaluation.
  • You may refer to strong antibiotics and steroids for treating bacterial and viral meningitis.
  • If you are suffering from mild hearing loss, hearing aids will be the best option.
  • In case of severe hearing loss due to meningitis, an audiologist will suggest cochlear implants for you.

Hearing loss is a medical problem that may require medicinal consideration, so it is essential not to avoid it. Consult your doctor or audiologist for medical help.

More FAQ’s

Meningitis And Hearing Loss: Everything You Need To Know

According to Mayo Clinic, meningitis can be caused by different infections â a virus, bacteria, and even fungus. These infections can spread to different parts of the body, including the ear. A 2018 study published in the Pakistan Journal of Medical Sciences found that, when evaluating the results of meningitis on young children, 22% experienced some sort of hearing loss.

âEven though meningitis can happen to anyone, individuals over 65 and younger than 25 are the most at risk for developing hearing loss,â Ronen Nazarian, MD, an otolaryngologist in Los Angeles, CA tells WebMD Connect to Care. âThis is because of extension of the infection into the inner ear structures including the cochlea and the auditory nerve,â Nazarian says.

The cochlea is a part of the inner ear containing the hair cells responsible for transmitting sound waves into electrical impulses to the brain so it can interpret sound. According to Nazarian, meningitis can damage the hair cells in the ear. Another potential impact is where a part of the cochlea hardens into bone, which will eventually prevent any future hearing loss treatments from working.

While hearing loss can occur during/after meningitis, there are symptoms to watch out for. Some symptoms of meningitis include fever, vomiting, and/or a stiff neck.

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Association Between Vestibular Dysfunction And Hearing Loss After Meningitis

From the studies referenced above, it appears that some association does exist between hearing loss and vestibular loss after meningitis, which makes sense as the inflammation/infection may spread to all compartments of the inner ear . However, Levo et al. investigated 23 patients with bilateral vestibular hypofunction as measured with a motorized head impulse test. In seven cases, the etiology was meningitis. Two of these patients had normal hearing. Accordingly, and as also noted above, vestibular dysfunction may occur without hearing loss, whereas the opposite appears to be rare. Thus, the vestibular system may be the first part of the inner ear to be affected in humans, whereas cochlear involvement appears to be first in line in other species . This perspective increases the relevance of performing a screening of not only hearing but also vestibular function in all patients surviving meningitis.

How Is Meningitis Treated

Causes of hearing loss

Most cases of viral meningitis end within 7 to 10 days. Some people might need to be treated in the hospital, although kids usually can recover at home if they’re not too ill. Treatment to ease symptoms includes rest, fluids, and over-the-counter pain medicine.

If bacterial meningitis is diagnosed or even suspected doctors will start intravenous antibiotics as soon as possible. Fluids may be given to replace those lost to fever, sweating, vomiting, and poor appetite.

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Meningitis Hearing Loss Treatment & Recovery

The first 48 hours are crucial in treating meningitis as a way of reversing hearing loss. Going for regular medical checkups is the only way to find out if youre suffering from meningitis and related hearing loss symptoms.

Hearing loss can reoccur later even after treatment of meningitis. Therefore, its imperative that you undergo regular screenings and evaluations to prevent possible reoccurrence of this condition.

Children with meningitis should undergo hearing loss tests at least four times during the first year of infection. If your child tests positive for hearing loss after the first test, you should take him or her for testing every three weeks for the first six months.

How Are Meningitis And Encephalitis Diagnosed

Following a physical exam and medical history to review activities of the past several days or weeks , the doctor may order various diagnostic tests to confirm the presence of infection or inflammation. Early diagnosis is vital, as symptoms can appear suddenly and escalate to brain damage, hearing and/or speech loss, blindness, or even death.

Diagnostic tests include:

  • A neurological examination involves a series of physical examination tests designed to assess motor and sensory function, nerve function, hearing and speech, vision, coordination and balance, mental status, and changes in mood or behavior.
  • Laboratory screening of blood, urine, and body secretions can help detect and identify brain and/or spinal cord infection and determine the presence of antibodies and foreign proteins. Such tests can also rule out metabolic conditions that may have similar symptoms.
  • Analysis of the cerebrospinal fluid that surrounds and protects the brain and spinal cord can detect infections in the brain and/or spinal cord, acute and chronic inflammation, and other diseases. A small amount of cerebrospinal fluid is removed by a special needle that is inserted into the lower back and the fluid is tested to detect the presence of bacteria, blood, and viruses. The testing can also measure glucose levels and white blood cells , as well as protein and antibody levels.

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How Are These Infections Treated

People who are suspected of having meningitis or encephalitis should receive immediate, aggressive medical treatment. Both diseases can progress quickly and have the potential to cause severe, irreversible neurological damage.

Meningitis

Early treatment of bacterial meningitis involves antibiotics that can cross the blood-brain barrier . Appropriate antibiotic treatment for most types of meningitis can greatly reduce the risk of dying from the disease. Anticonvulsants to prevent seizures and corticosteroids to reduce brain inflammation may be prescribed.

Infected sinuses may need to be drained. Corticosteroids such as prednisone may be ordered to relieve brain pressure and swelling and to prevent hearing loss that is common in Haemophilus influenza meningitis. Lyme disease is treated with antibiotics.

Antibiotics, developed to kill bacteria, are not effective against viruses. Fortunately, viral meningitis is rarely life threatening and no specific treatment is needed. Fungal meningitis is treated with intravenous antifungal medications.

Encephalitis

Antiviral drugs used to treat viral encephalitis include acyclovir and ganciclovir. For most encephalitis-causing viruses, no specific treatment is available.

Autoimmune causes of encephalitis are treated with additional immunosuppressant drugs and screening for underlying tumors when appropriate. Acute disseminated encephalomyelitis, a non-infectious inflammatory brain disease mostly seen in children, is treated with steroids.

Bacterial Meningitis And Deafness

Infection and Hearing Loss: Audiology

What is Bacterial Meningitis?

According to the CDC, Bacterial Meningitis is an extremely serious infection that attacks the Central Nervous System and is caused by a certain type of bacteria. While the outcome of recovery for most individuals is high, some people end up with permanent disabilities, like deafness. The type of deafness that can occur from Bacterial Meningitis is Sensorineural Deafness. If Bacterial Meningitis is diagnosed in an individual, immediate treatment is recommended.

Why Does Bacterial Meningitis Cause Deafness?

Bacterial Meningitis attacks the Central Nervous System and can cause Sensorineural Deafness, which is damage to the Inner Ear. The ear is comprised of three parts: Outer Ear, Middle Ear and Inner Ear.

The Outer Ear is comprised of the pinna and ear canal. The direction of sound and where it comes from is determined by the pinna. The Middle Ear is comprised of three small bones called ossicles. The ossicles connect the eardrum to the Inner Ear. Different pitches of sound cause the eardrum to move. Once the eardrum hears a sound, the ossicles move and send a sign to the Inner Ear.

The Inner Ear is responsible for an individuals hearing and balance . When damage occurs from Bacterial Meningitis, listening to soft sounds can become hard. Listening to louder sounds can become distorted or unclear and also sound muted.

Treatments for Sensorineural Deafness

Resources

Hearing Loss Association of America, HLAA

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Hearing Aids Can Help With Meningitis Hearing Loss

The effects of meningitis include the loss of hair cells in the inner ear, which leads to mild-to-medium hearing loss. Further physical damage of inner ear structures can result in a profound hearing loss. Meningitis can also leave a person with Tinnitus: a persistent whooshing or ringing-in-the-ears sound.Modern hearing aids can help remedy all but the most profound cases of hearing loss, and help alleviate Tinnitus symptoms, too. A profound hearing loss may benefit from cochlear implants.

What Is The Prognosis For These Infections

Outcome generally depends on the particular infectious agent involved, the severity of the illness, and how quickly treatment is given. In most cases, people with very mild encephalitis or meningitis can make a full recovery, although the process may be slow.

Individuals who experience only headache, fever, and stiff neck may recover in 2-4 weeks. Individuals with bacterial meningitis typically show some relief 48-72 hours following initial treatment but are more likely to experience complications caused by the disease. In more serious cases, these diseases can cause hearing and/or speech loss, blindness, permanent brain and nerve damage, behavioral changes, cognitive disabilities, lack of muscle control, seizures, and memory loss. These individuals may need long-term therapy, medication, and supportive care.

The recovery from encephalitis is variable depending on the cause of the disease and extent of brain inflammation.

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