DIPHTHERIA is usually regarded as a disease affecting the cranial and peripheral nerves rather than the central nervous system. This undoubtedly is true of most cases of the disease with neurologic complications. However, the central nervous system is not always spared in diphtheria, even though many cases with neurologic manifestations have shown no anatomic changes in the brain. The literature contains a number of pathologic reports of cerebral hemorrhage, meningitis, degeneration of ganglion cells and nerve tracts, polyradiculoneuritis of Guillain-Barré and encephalitis occurring as a complication of diphtheria.
Cerebral hemorrhage, usually manifested by hemiplegia, is the most frequent lesion of the central nervous system and is generally the result of embolism from mural thrombi of the left side of the heart. Meningitis is an infrequent complication of diphtheria. It can be caused by the Corynebacterium diphtheriae (Carlson and Morgan1) or, in septic complications, by the streptococcus (Doskočil2). Degenerative