There are two Aeromedical concerns following meningitis of encephalitis:
Neurological sequelae: The ME should in all cases complete a thorough neurological examination, inclusive of an audiogram. Anyone who has suffered from an episode of meningitis or encephalitis should also undergo a neurologist evaluation unless the infection was documented to be uncomplicated viral (other than herpetic) or bacterial meningitis, occurring more than 12 months previously, in the absence of any sequelae or seizure episode.
Risk of unprovoked seizures: This risk is significant and was found in one study to be 6.8 % over 20 years in one study. The ratio of observed to expected case of unprovoked seizures was 6.9. The risk was highest during the first 5 years but remained elevated for the next 15 years of follow up. It was dependent on the type of infection. This is summarised in the table below – adapted from Annegers (1988):
|Condition||Risk of unprovoked seizure||Comments|
|Viral encephalitis (nonHerpes) with early seizures||22% over 20 years|
|Viral encephalitis (nonHerpes) without early seizures||10% over 20 years|
|Viral meningitis (non-Herpes)||2.1% over 20 years||No significant increase over general population|
|Bacterial meningitis with early seizures||13% over 20 years|
|Bacterial meningitis without early seizures||2.4% over 20 years||No significant increase over general population|
Thus the ME must remain cautious in assessing any applicant with a history of meningitis or encephalitis.
An applicant with a history of uncomplicated, viral (non-Herpes), or uncomplicated bacterial meningitis should be considered as having a condition that is aeromedical significance unless: