Cerebral malaria is the most severe neurological complication of
infection with Plasmodium falciparum malaria. It is a clinical syndrome characterized by coma and asexual forms of the parasite on peripheral blood smears.On the other hand, CNS manifestations are fairly common in
malaria and it could be due to not only severe P. falciparum infection, but also high-grade fever and antimalarial drugs. Therefore, it is extremely important to differentiate between these so as to avoid unnecessary
anxiety and improper treatment.Manifestations of cerebral dysfunction include any degree of impaired consciousness, delirium, abnormal neurological signs, and focal and generalized convulsions. In severe P. falciparum malaria, the neurological dysfunction can manifest suddenly following a generalized
seizure or gradually over a period of hours.To distinguish
cerebral malaria from transient postictal coma, unconsciousness should persist for at least 30 min after a convulsion. The deeper the coma, the worse is the prognosis. If necessary, a lumbar puncture should be performed to rule out bacterial meningitis. However, all patients with P. falciparum
malaria with neurological manifestations of any degree should be treated as cases of cerebral malaria.
Relevant Topics in Neuroscience & Psychology
