The CT-Scan is particularly useful in identifying such a complication. Subdural empyema is usually associated with paranasal and otitic infection. It needs to be suspected if meningitis is associated with raised intracranial pressure, seizures and focal signs. Again the CT-Scan is indicated whenever such a possibility is suspected. The level of consciousness on admission is of paramount importance for prognosis.
Epilepsy is more common in the neonates and infants.
In adults, fits appear to be less common and are often focal and may be associated with hemiparesis, as a Todd's phenomena. Cranial nerve involvement is common, usually affecting the nerves controlling ocular movement. This is often due to vasculitis, basal exudation or brainstem distortion from raised intracranial pressure. A high index of clinical suspicion, supported by signs of meningeal irritation is the primary requisite for the diagnosis of meningitis. The ideal site to obtain C.S.F. is by a lumbar tap.