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

Duque, Vítor; Seixas, Daniela; Ventura, Conceição; Cunha, Saraiva da; Meliço-Silvestre, A.

doi:10.3855/jidc.2177

Cited by 8 publications

(9 citation statements)

References 20 publications

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“…Although psychiatric symptoms are only rarely associated with delayed cerebellar syndromes in the literature, when reported, these have included giddiness [ 56 ], alterations in attention [ 60 ], and word-finding difficulties [ 61 ].…”

Section: Introductionmentioning

confidence: 99%

Psychiatric effects of malaria and anti-malarial drugs: historical and modern perspectives

Nevin

Croft

2016

Malar J

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The modern medical literature implicates malaria, and particularly the potentially fatal form of cerebral malaria, with a risk of neurocognitive impairment. Yet historically, even milder forms of malaria were associated in the literature with a broad range of psychiatric effects, including disorders of personality, mood, memory, attention, thought, and behaviour. In this article, the history of psychiatric effects attributed to malaria and post-malaria syndromes is reviewed, and insights from the historical practice of malariotherapy in contributing to understanding of these effects are considered. This review concludes with a discussion of the potentially confounding role of the adverse effects of anti-malarial drugs, particularly of the quinoline class, in the unique attribution of certain psychiatric effects to malaria, and of the need for a critical reevaluation of the literature in light of emerging evidence of the chronic nature of these adverse drug effects.

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Section: Introductionmentioning

confidence: 99%

Psychiatric effects of malaria and anti-malarial drugs: historical and modern perspectives

Nevin

Croft

2016

Malar J

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“…Bilateral sixth cranial nerve palsy due to Plasmodium falciparum malaria has been reported in a 14-year child. 7 Bell's palsy is a facial nerve palsy involving the lower motor neuron. Bell's palsy results in weakness of facial muscles.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Facial Palsy: Post Vivax Malaria Scenario

Sawardekar¹,

Patil²,

Badgujar³

et al. 2016

jemds

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Malaria can cause severe complications, sometimes affecting central nervous system. Cranial nerve palsies are rare after malaria. Plasmodium vivax malaria, often thought to be a benign disease can sometime lead to severe complications. We report a case of lower motor neuron palsy after plasmodium vivax malaria. KEYWORDSFacial Palsy, Vivax Malaria. HOW TO CITE THIS ARTICLE: INTRODUCTIONMalaria is a common health problem in tropical countries like India. Of the four plasmodium species causing malaria in humans, P. vivax is the most widespread. P. vivax malaria in India is more prevalent than plasmodium falciparum. 1 In India P. vivax and P. falciparum accounts for about 60-65% and 35% cases respectively. 2 P. vivax is often thought to be benign infection; however, it may sometime result in severe complications affecting different organs. 3 Commonly reported severe complications of P. vivax malaria include haematological problems, such as anaemia and thrombocytopenia, liver or kidney dysfunction, lung related complications, hypoglycaemia, shock and cerebral malaria. 2,3 We report here an unusual case of bilateral lower motor neuron palsy after P. vivax malaria.

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“…It has been postulated that malaria parasite may damage the peripheral nerves by vascular occlusion, thus causing anoxic stagnation in the vasa nervosum, which may lead to temporary demyelination and recovery after disappearance of the parasitemia and establishment of normal blood flow in the vasa nervosum [8]. In malaria, asexual-stage infections are accompanied by the release of cytokines and other immunological mediators that may mimic Guillain-Barre syndrome [9,13]. It is likely that these immunological mediators may have caused demyelination in the index patient giving rise to Gullain-Barre like syndrome affecting only the facial nerve.…”

Section: Discussionmentioning

confidence: 99%

“…Recovery of facial paralysis due to Bell's palsy begins within three weeks of onset of the illness with complete recovery occurring within three to six months [7]. Sim et al, [8] reported facial diplegia in a 20 year old boy infected with Plasmodium vivax in Korea while Duque et al, [9] reported bilateral 6 th cranial nerve palsy caused by P. falciparum in a 14 year old Caucasian living in Democratic Republic of Congo. Haematological response to malaria infection has been documented.…”

Section: Introductionmentioning

confidence: 99%

Facial nerve palsy: an unusual feature of Plasmodium falciparum

Okike¹,

Ezeonu²,

Onyire³

et al. 2013

Paediatr Health

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A ten-year old boy who presented with headache, intermittent high grade fever for four days and left sided deviation of the mouth two days later. Examination revealed a fully conscious patient with an axillary temperature of 39.5 0 C and right facial nerve palsy, lower motor neuron lesion. No other obvious abnormality was detected in any of the systems. Laboratory examination showed positive Plasmodium falciparum (P. falciparum) with a density of 28,000 parasites/mm 3 . Cranial computerized tomographic scan and abdominal ultra-sonograghy revealed no abnormality. Cerebrospinal fluid (CSF) analysis showed normal cell count and chemistry. Culture yielded no growth. Retroviral screening test was negative. Complete blood count showed high monocytosis of 18%, other indexes were normal. Electrolytes, urea, creatinine and calcium levels were within normal limits. Urine, stool and blood cultures yielded no growth. Random blood sugar (RBS) and liver function test were normal. Symptoms subsided within 36 hours following administration of intravenous artesunate and oral paracetamol. Complete facial nerve recovery took seven days following clearance of parasitemia. The objective of this report is to draw the attention of clinicians to this uncommon presentation of malaria, though the patho-physiological mechanism remains unclear.

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

Cited by 8 publications

References 20 publications

Psychiatric effects of malaria and anti-malarial drugs: historical and modern perspectives

Psychiatric effects of malaria and anti-malarial drugs: historical and modern perspectives

Bilateral Facial Palsy: Post Vivax Malaria Scenario

Facial nerve palsy: an unusual feature of Plasmodium falciparum

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