[P2-77] A CASE OF BACTERIAL MENINGITIS WITH LOCAL ONSET ON ICTAL EEGS
[Introduction]Bacterial meningitis is a central nervous system infection and inflammation of the meninges. Seizures often occur in children with meningitis, however there are no reports of ictal EEGs during a seizure in meningitis. We experienced the recording of focal discharge on ictal EEGs during a seizure in meningitis. [Case] The patient was a five month old female. Her perinatal histories showed nothing in particular. Her developmental history up to five months also recorded no complications. Her vaccination history included only BCG. She had convulsions with fever twice a day just before hospital admission. A neurological examination also showed normal findings. Her consciousness was clear between convulsions. The cranial magnetic resonance imaging (MRI) was also normal. The third convulsion occurred during the recording of the EEG. The paroxysmal discharges were recorded with focal onset. Cerebrospinal fluid (CSF) cell counts revealed increased leukocytes (816/3), including 33% lymphocytes and 67% neutrophils. Penicillin-susceptible S.pneumoniae (PSSP) was detected in the blood and in the CSF culture specimens taken on the day of admission. We diagnosed her convulsion were caused from bacterial meningitis of PSSP. She had been no sequelae for 2 years, but developed epilepsy 3 years later after onset. [Conclusions] In spite of an inflammation of the whole brain, paroxysmal discharges on ictal EEG were of focal onset. It is presumed that the inconsistency is caused by the child’s epileptogenicity, subtle inflammation, or the immaturity of the brain.