NEURODEVELOPMENTAL OUTCOME OF INFANTS WITH VIRAL MENINGITIS IN THE FIRST 3 MONTHS OF LIFE

We prospectively evaluated the neurodevelopmental outcome of infants w ith documented viral meningitis to determine (1) whether deficits in p hysical growth, development, speech and language, hearing, or intellig ence occur; and (2) if so, at what age these deficits can be detected. Sixteen infants with documented enteroviral meningitis under the age of 90 days and a control group of 13 patients matched for age, race, s ex, and socioeconomic status were followed up prospectively for 3 year s with annual evaluations, which included a developmental evaluation b y a pediatric developmentalist, articulation and language tests by a s peech-language pathologist (Sequenced Inventory of Communication Devel opment, Receptive-Expressive Emergent Language Scale (REEL), Preschool Language Scale (PLS), Revised Peabody Picture Vocabulary Test (PPVT-R ), Photo Articulation Test, audiometric screening), and intelligence t ests by a psychometrist (Bayley Scales of Infant Development [BSID] an d Stanford-Binet). No deficits were demonstrated in growth, developmen t, hearing, BSID, articulation, and expressive language. Subtle but si gnificant (P < 0.05) deficits were documented in the study group compa red with the control group in the receptive component of the REEL, all subsections of the PLS, the PPVT-R, and the verbal comprehension/lang uage-processing section (Factor II) of the Stanford-Binet. These diffe rences could be reliably detected by 3 years of age. We conclude that viral meningitis in young infants may cause subtle deficits in languag e skills, particularly receptive language. We recommend that children who have had enteroviral meningitis during early infancy be monitored carefully for language development and, perhaps, receive increased lan guage stimulation in the home prior to school entry in order to optimi ze their learning potential.