Neurological Disorders Forum - ? Sequelae of Meningitis From Rmsf Headaches & Mri Resul

patient hx:

male, 49 (my husband)

7/11/03 had viral meningitis, id doc ruled out any infectious agents, determined it to be enterovirus. Confirmed by ct, lumbar puncture (lp), and blood labs. Treated at er, released. Readmitted 18 hours later with dehydration and kept for 3 days. Headache took 3 months to resolve entirely....

Fast forward 3 years.....

8/31/06 admitted to er with symptoms: low-grade fever, meningitis headache, nuchal rigidity. Ct, lp, cbc confirm meningitis, however they can't rule out rocky mountain spotted fever as the csf results were consistent for aeseptic meningitis and rmsf. Started on doxycyline. Treated and released. Readmitted the following day when he couldn't keep meds down due to vomiting. Kept for 3 days. Id doctor confirmed rmsf titer and stated that meningitis was a 'complication'.

My husband never had any rmsf symptoms, just developed meningitis which we were all too familiar with.

9/20/06 still has low-grade fever, post-lp headache. Doc repeats cbc to rule out anything infectious before performing a blood patch at the lp site.
Send him home to drink lots of caffeine and take 800mgs ibuprofen and stay on back for 48 hours while they wait on cbc.

9/22/06 performs blood patch. It's only marginally successful and very painful 'like i've been kicked in the back by a horse'. Still has headache and no relief.

November.... Regular doc prescribes tramadol for pain, helps, but no meds have relieved headache.

January ... Regular doc now concerned at duration of headache and refers to 'headache' wellness center to see a neurologist. Appointment is 5 weeks away!!!!!

We called to get on 'cancellation' list and he was seen last monday. Mri with contrast on tuesday. We got results today (finally), and they are:

"abnormalities in brain, probably relates to inflammation from rmsf"

i spoke to the doc and he said this is 'stable' and will probably be there forever, that it's (like?) scar tissue in the brain. (umm - is that 'like' as in it is scar tissue, or is that 'like' as in it's technically called something else and he didn't think i'd 'understand' 'like'?????) and that the headache is 'brain irritability' that will 'hopefully' go away in time.

His 'follow-up' appt is in 2.5 weeks, so he won't get to ask any ?'s till then.

Ok, getting to the point:

what the heck does this mean?
Is he at an increased risk for seizures? Dementia? Stroke?
Are there potential 'complications' to these "so-called" stable brain 'abnormalities'?
Is there a correct medical term for what we are dealing with because i've 'googled' every combination I can think of and am not coming up with much?

We are requesting his mri images be sent to us so we can get them seen by another (as many other) set(s) of eyes.

The neurologist apparently doesn't feel there is any 'treatment' for this and that my husband will have to continue trying to 'live' with an excruciating headache that never goes away. All the while 'hoping' that it will improve with time.

They did start him on imipramine with hopes that it will 'fool' his brain into thinking he's not in as much pain as he really is in. It technically won't work as a preventative because he already has a headache. Also took him off all otc pain relievers to avoid rebound headaches, but will allow him to use tramadol 'occasionally'.

If anyone can help, please reply!

Laura, the wife
... Who reads a lot of medical journals in her spare time.....