Cerebellar syndrome in Plasmodium falciparum malaria

Kochar, Dhanpat Kumar; Shubhakaran,; Kumawat, Banshi Lal; Thanvi, I; Agrawal, Neeraj

doi:10.1093/qjmed/92.4.233

Cited by 14 publications

(8 citation statements)

References 4 publications

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“…[ 4 ] Cerebellar involvement in P. falciparum malaria can occur during the acute stage of fever as sequelae of cerebral malaria among survivors or as a side effect of drugs, which is evident as delayed cerebellar ataxia. [ 5 ] However, isolated nystagmus in children after severe malaria is very rarely reported[ 5 ] although ataxia and tremor are commonly observed. The cerebellar symptoms are due to injury to Purkinje cells as a consequence to hyperpyrexia, anemia, hypoglycemia and persistent seizures eventually leading to hemorrhages, small infarction, and the microglial infiltration in Purkinje cells of the cerebellum.…”

Section: Discussionmentioning

confidence: 99%

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Case reports on atypical presentation of Plasmodium falciparum malaria in pediatric patients

2015

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Variable atypical symptoms are commonly observed in malaria caused by Plasmodium falciparum especially in endemic tropical nations such as India. Nystagmus is observed following involvement of the cerebellum especially during the postrecovery phase. While psychotic features such as severe agitation, hallucination, paranoia may be the early symptoms of falciparum malaria among pediatric patients, urticaria with or without fever can be the initial manifestation of the disease. As the morbidity and mortality of severe malaria are very high in India, these atypical presentations should be considered during diagnosis. We believe our report on atypical cases of falciparum malaria will sensitize doctors and health personnel about rare presentations in children and help in early diagnosis and management to reduce the severity and death toll due to the disease.

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Section: Discussionmentioning

confidence: 99%

“…The cerebellar symptoms are due to injury to Purkinje cells as a consequence to hyperpyrexia, anemia, hypoglycemia and persistent seizures eventually leading to hemorrhages, small infarction, and the microglial infiltration in Purkinje cells of the cerebellum. [ 4 5 ]…”

Section: Discussionmentioning

confidence: 99%

Case reports on atypical presentation of Plasmodium falciparum malaria in pediatric patients

2015

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“…Chronic acquired hepatocerebral degeneration (CAHD) is a disorder characterized by the presence of extrapyramidal (choreoathetosis, tremor, myoclonus, dystonia, rigidity, dysarthria, and ataxia) and/or neuropsychiatric symptoms (apathy, lethargy, somnolence, cognitive impairment) in patients with acquired liver dysfunction. 1,2 We describe the clinical characteristics and therapeutic interventions in a patient who developed CAHD secondary to end-stage liver disease from hepatitis C.…”

Section: Management Of the Extrapyramidal Syndrome In Chronic Acquirementioning

confidence: 99%

Presymptomatic Hypertension Is a Major Feature in the Diagnosis of Progressive Supranuclear Palsy

Ghika

Bogousslavsky²

1997

Archives of Neurology

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A presymptomatic history of HT is a major feature in the clinical history of progressive supranuclear palsy and may be a diagnostic criterion. Its significance is unknown, but adrenergic nuclei of the brainstem are severely affected, and HT may be the first symptom arising from involvement of these nuclei. This could also explain the features of small vessel disease seen on computed tomography or magnetic resonance imaging in 50% of our patients, as in previous reports.

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“…Most cases described in the literature occurred in adults living in endemic areas for malaria, mainly in Asia and Africa, but additional cases were described in non-immune hosts (93%) who travelled to endemic countries without taking prophylaxis [3]. Cerebellar involvement in P. falciparum malaria can occur during the acute stage of fever, as sequels of cerebral malaria in survivors, in the form of delayed cerebellar ataxia (DCA) and as a side effect of drugs [4]. Two syndromes of cerebellar ataxia have been recognized: acute (or early) cerebellar ataxia and delayed (or late) cerebellar ataxia [5,6].…”

Section: Introductionmentioning

confidence: 99%

Plasmodium falciparum malaria, bilateral sixth cranial nerve palsy and delayed cerebellar ataxia

Duque

Seixas

Ventura

et al. 2011

J Infect Dev Ctries

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We describe the case of a 14-year-old Caucasian male, a resident in the Democratic Republic of the Congo, who was observed in Portugal with severe Plasmodium falciparum malaria with high-level parasitemia and severe thrombocytopenia. The course was complicated by bilateral sixth cranial nerve palsy during acute malaria, followed by the appearance of delayed cerebellar ataxia during the recovery phase. This occurred after successful treatment with quinine plus doxycycline over seven days. Different levels of thrombocytopenia and C-reactive protein were observed during both neurologic events in the presence of HRP-2 positive tests for Plasmodium falciparum antigen. The patient recovered completely after three months.

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Cerebellar syndrome in Plasmodium falciparum malaria

Cited by 14 publications

References 4 publications

Case reports on atypical presentation of Plasmodium falciparum malaria in pediatric patients

Case reports on atypical presentation of Plasmodium falciparum malaria in pediatric patients

Presymptomatic Hypertension Is a Major Feature in the Diagnosis of Progressive Supranuclear Palsy

Plasmodium falciparum malaria, bilateral sixth cranial nerve palsy and delayed cerebellar ataxia

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