Cerebral malaria and post-malarial neurological syndrome
Keywords:
cerebral malaria, coma, Plasmodium falciparum, post-malarial neurological syndrome, quinineAbstract
The cerebral form of severe Plasmodium falciparum malaria is the commonnest and most important of the many neurologícal manifestations and complicatíons of malaria.
The purpose of this article is to review, in some detail, our knowledge of cerebral malaria.
By definition, cerebral malaria requires coma to persist for at least 30 minutes, alter a generalized convulsion, to make the distinction from transient postictal coma (this doesn't make sense as a definition - it only refers to cerebral malaria associated with convulsions). However, in clinical practice, any patient with asexual forms of P. falciparum in the peripheral blood and impaired consciousness, alter exclusion of other aetiologies, should be urgently treated as "cerebral malaria".
Post-malarial neurological syndrome (PMNS), a self-limiting transient syndrome of median duration, can develop alter severe falciparum malaria. PMNS has been strongly associated with mefloquine treatment, although this does not account for all cases.
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References
Olliaro P, Cattani J. Wirth D. Malaria, the submerged disease. JAMA 1996: 275: 230-233.
White N. J. Malaria. in: Manson's Tropical Diseases. 18'" Edition. Bailliére Tindall, 1984: 39-71.
World Health Organization. Severe and complicated malaria. 2 nth eds. Trans R S Tropical Med Hygiene 1986; 80 (suppl 2): 1-65.
David J. Wiler.Plasmodium species (Malaria) in: Gerald L. Mandei], MD. Principies and Practice of lnfectious Diseases, a Willey Medical Publication. 1985; 1514-1522.
Carlson J, Nash G, Gabutti V, AI-Yaman F,Wahlgren M. Natural protection against severe Plasmodium falciparum Malaria due to impaired rosette formation. Blood 1994: 84: 3909-3914.
Canfield C. Chongsuphajaisiddhi T. Dannis M et ai. Severe and complicated malaria. Trans R Soe Trop Med Hyg 1990: 84: 1-65.
Cot S. Ringwald P. Mulder B et ai. Nitric oxide in Cerebral Malaria. J lnf Dis 1994; 169: 1417-1418.
Clark 1. Rockett K. Cowden W. Popssible central role of nitric oxide in conditions clinically similar to cerebral malaria. Lancet 1992: 34: 894-896.
Greenwood B. Fever and malaria. Lancei 1996: 348: 280-281.
Collomb H, Rey M, Dumas M, Nouhouayi A. Petit M. Les hemiplegies au cours du paludisme aigu. Buli Soe Méd Af Noire Lgue Fr 1967; XII, 4: 791-795.
Kampfl A. Birbamer G. Pfauusler B, Haring H. Schmutzhard. Isolated pontine lesion in algid cerebral malaria: clinical features. management, and magnetic resonance imaging findings. Am J Trop med Hyg 1993: 48: 818-822.
Mai N. Day N, Chuong L et at. Post-malaria neurological syndrome. Lancet 1996; 348: 917-921.
Dollow S. Neurological sequelae of cerebral malaria. Lancet 1996;348: 1658-1659.
Brewster D. Kwiatkowski D, White N. Neurological sequelae of cerebral malaria in children. Lancet 1990: 336: 1039-1043.
Carme B. Bouquety J. Plassart H. Mortality and sequelae due to cerebral malaria in african children in Brazaville. Congo. Am J
Trop Med Hyg 1993: 48(2): 216-221.
Chia J. Nakata M. Co S. Smear-negative cerebral malaria due to mefloquine-resistant palmodium falciparum acquired in the amazon. J lnf Dis 1992; 165:599-60.
Garcia M. Kirimoama S, Marlborough D, Leafasia J. Rieckmann K. immunochromatographic test for malaria diagnosis. Lancet 1996: 347: 1549.
White N. The treatment of malaria. N Eng J Med 1996: 335:800-806.
Luzzi G. Peto T. Adverse effects of antimalarials. An update. Drug Safety 1993; 8(4): 295-311.
F. Antunes et al. Malaria in Portugal 1997-1998. Transactions of the Royal Society of Tropical Medicine and Higiene 1987; 81:561-562.
Fargier J J. Louis F J. Cot M, Maubert B. Hounsinou C. Louis J P. Le Bras J. Touze J E. Reduction of coma by quinine loading dose in falciparum cerebral malaria. Lancet 1991: 338: 896-897.
Donadio J. Whelton A. Kazyak L. Quinine therapy and peritoneal dialysis in acute renal failure complicating malariat haemoglobinuria. Lancet 1968; 375-379.
Maglia J. Rozalén I. Chordá R. Falia multiorgânico en el paludismo por Plasmodium falciparum. Rev Clin Esp 1995; 688-692.
Lichtman A. Early haemodiatysis and mortality in patients with renal faiture due to falciparum mataria. intensive Care World 1994;11: 66-67.
Hoffman S. Artemether in severe malaria - still too many deths. N Eng J Med 1996; 335: 124-125.
Hien T. Qinghaosu W N. Lancet 1993; 341: 603-608.
Gordeuk V. Thuma P. Brittenham G et al. Iron chelation as a chemotherapeutic strategy for falciparum mataria. Am J trop Med Hyg 1993: 48(2): 193-197.
Wong R. Murthy A. Mathissen G. Glover N. Thornton P. Treatment of severe falciparum malaria during pregnancy with quinidine and exchange transfusion. Am J Med 1992; 92: 561- 562.
Wyler D. Bark. Weeds, and iron cheLators - drugs for malaria. N Eng J Med 1992; 327: 1519-1521.
Gordeuk V. Thuma P. Brittenham G et ai. Effect of iron chelation therapy on recovery from deep coma in children with cerebral malaria. N Eng J Med 1992; 327: 1475-1477.
Warret D. Looareesuwan S. Warrel M et al. Dexamethasone proves deleterious in cerebral malaria. A double- blind triai in 100 comatose patients. N Eng J Med 1982; 306: 313-319.
P. Proença, T. Cabral, L. Ferreira, G. do Carmo: Malária-estudo retrospectivo de 7 anos ( 1989-1995) do serviço de Doenças Infecciosas do H. de Santa Maria. Revista Portuguesa de Doenças Infecciosas. ano 19. nº2-3; 1996; 173.179. 180- 186
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