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Seizures Learning Center
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Epidemiology and microbiology: the overall annual incidence of bacterial meningitis is about 2?3/100,000, with peaks of incidence in infants and adolescents. Integration of vaccines into the UK vaccination programme against Haemophilus influenzae type b (Hib) and more recently against group C meningococccus has led to a marked decline in cases of Hib and Group C meningococcal meningitis and has significantly reduced the overall incidence of bacterial meningitis.
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Meningitis is the most common serious manifestation of infection of the central nervous system (CNS). Inflammatory involvement of the subarachnoid space with meningeal irritation leads to the classic triad of headache, fever and meningism, and to a pleocytosis in the cerebrospinal fluid (CSF).
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The central nervous system (CNS) has no lymphatic system as such, and although usually well protected from direct infection, its resistance to any infection that does occur is low. The patterns of infective illness are relatively few, but the organisms that can produce disease are many.
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Systemic lupus erythematosus is an autoimmune connective-tissue disorder with a wide range of clinical features, which predominantly affects women, especially from certain ethnic groups. Diagnosis is based on clinical assessment supported by investigations, including the finding of autoantibodies.
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Nothing in clinical neurology exceeds the demands on the clinician more than diagnosing and managing the patient with headache, a process that demands a combination of clinical skill and good interpersonal relationships. The physician dealing with the patient who presents with headache will by the history determine the likely diagnosis; by the brief, structured examination receive some reassurance that there is no lurking lesion causing the problem; and by his or her ability to see past the patient's naive words of complaint, recognize a pattern of symptomatology, allowing a confident diagnosis that will allow equally confident management.
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