Neuropsychiatric Manifestations of Typhoid Fever in 959 Patients

The neurospsychiatric manifestations of typhoid fever in 959 Nigerian patients included confusional states or delirium (57%), semicoma (2.6%), coma (1.0%), meningism (5%), meningitis (0.2%), convulsions (1.7%), generalized myoclonus (0.5%), focal neurological deficit— deafness, hemiplegia, infranuclear facial palsy— (0.5%), transient or evanescent parkinsonism (1.0%), symmetrical, usually transient, spasticity of all limbs (3.1%), and generalized hypotonicity (0.2%). Seven patients had symmetrical sensorimotor polyneuropathy without cytoalbuminological dissociation in cerebrospinal fluid, and three patients had a mononeuritis. One young man developed motor neuron disease two months after recovering from typhoid fever. In five patients (0.5%), the initial diagnosis was schizophrenia. Two developed schizophrenic psychoses, and two other patients suffered from temporary amnesia during convalescence.