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Meningitis

Photo: All children with confirmed or suspected bacterial meningitis should have their hearing tested

Deafness is the most common after-effect of bacterial meningitis. Approximately one in ten children who have meningitis develop deafness as a result of the illness.

What is meningitis?

Meningitis is inflammation of the meninges (membranes) that surround and protect the brain and spinal cord. It is usually caused by a bacterial or viral infection.

Meningitis can affect anyone, of any age, at any time. However babies, toddlers and children under five are the group most at risk from meningitis, with young people aged 15–19 the next most vulnerable.

What type of deafness does meningitis cause?

Bacterial meningitis is known to cause sensorineural deafness. Sensorineural deafness happens when there is a fault in the inner ear or the auditory nerve that carries sound signals to the brain. Sensorineural deafness is permanent.

Meningitis can cause sensorineural deafness in a number of ways. The most common cause is the infection spreading in to the cochlea, damaging the hair cells. Another possible cause is inflammation of the auditory nerve. Deafness can range from mild through to profound and can affect one or both ears.

Viral meningitis isn’t usually associated with deafness.

Balance problems

The brain uses information from the eyes, our body and the inner ear to balance. The semicircular canals in the inner ears consist of three fluid-filled tubes and movement-sensitive hair cells. As we move, this causes fluid to move over the tiny hair cells. This creates signals that are sent to the brain about balance. 

If the infection affects the semicircular canals it can affect balance.

Older children may experience a feeling of dizziness and imbalance. In younger children balance problems may make it difficult for them to learn to do tasks that require balance such as sitting and walking. However, the brain is often able to compensate, and children often develop good mechanisms for managing any balance problems on a day-to-day basis. 

More information on deaf children and balance.

Meningitis Now has a factsheet on Problems with balance after meningitis

Tinnitus

Tinnitus may also be a side effect of meningitis. Tinnitus is a general term that means any sound that is heard that hasn’t come from an external source. These sounds might be ringing or buzzing for example. The majority of people have experienced tinnitus at some time, for example noticing a ringing in the ears following a gig or night out at a club. However, a much smaller number are worried or bothered by their tinnitus. Both deaf and hearing children can have tinnitus.

If tinnitus is noticed after recovering from meningitis, it’s important that this is discussed with your GP, audiologist, audiology doctor or ENT (Ear, Nose and Throat) consultant.

For more information on tinnitus visit www.tinnitus.org.uk

Meningitis Now has a factsheet on Hearing loss and tinnitus after meningitis

Hearing Tests

It is recommended that all children who have had confirmed or suspected bacterial meningitis are offered a hearing test within four weeks of being well enough to undertake testing, and preferably before they are discharged from hospital. 

It isn’t necessary for children who have had confirmed viral meningitis to be routinely referred for a hearing test. However, if you do have any concerns please ask your paediatrician or GP for a referral. 

Deafness usually happens early on in the course of the illness and it may be noticeable to the family before the first hearing test. If the deafness is less severe it may not be as immediately obvious. It is therefore important that children are tested early. 

Sometimes the deafness can get worse or change over time in the early days but it normally stabilises during the first few months following illness.

Emotional support for your child

A serious illness can have a deep emotional effect on any child. For an older child or teenager, this may mean that they need extra help finding new ways of communicating with you, and that they take a long time to accept their deafness.

It’s important that they have an opportunity to understand how their deafness will affect their life, and to talk about how they are feeling. Your child’s school or college should also be able to tell you about the extra support they can provide when your child returns to education.