Cerebellar syndrome in Plasmodium falciparum malaria (original) (raw)
Related papers
Delayed cerebellar ataxia: A rare self limiting complication of plasmodium falciparum malaria
Advanced Biomedical Research, 2013
The classic presentation of malaria with paroxysms of fever is seen only in 50%-70% of the patients. The development of immunity, the increasing resistance to anti-malarial drugs, and the indiscriminate use of anti-malarial drugs have led to malaria with the presentation of unusual features. Cerebellar ataxia, extrapyramidal rigidity and various psychiatric symptoms have been described either as early manifestations of cerebral malaria or as a part of post malaria neurological syndrome. In this case report, we will discuss one such patient of falciparum malaria infection who developed midline cerebellar signs, and responded to anti-malarial treatment.
Delayed Cerebellar Ataxia: A Rare Complication of Falciparum Malaria from a Non–endemic Area
Indian journal of applied research, 2016
PURPOSE-The purpose of this study is to understand the profile of the patients with delayed cerebellar ataxia due to plasmodium falciparum infection in a non-endemic area. METHODS-A retrospective chart review of diagnosed cases of malaria who presented with delayed cerebellar ataxia with positive blood smear for plasmodium falciparum between November 2014 and April 2015. RESULTS-A total of 17 patients were diagnosed to have malaria out of which 9 patients presented with delayed cerebellar ataxia. All the 9 patients were tested positive for plasmodium falciparum. None of these 9 patients had a previous history of malaria infection or its treatment. Mean duration between fever and ataxic symptoms was 14 days (Range: 7-28 days). All patients received artemether and lumifantrin combination. CONCLUSION-Delayed cerebellar ataxia is a self-limiting neurological complication of falciparum malaria. In a malaria endemic area, all patients with cerebellar ataxia with history of fever in the recent past should be investigated for malaria parasites in the blood. Once the parasite is documented, further evaluation of ataxia may be unnecessary especially in resource constrained regions while anti-malarial treatment should be initiated promptly and effectively to anticipate complete recovery.
Delayed Cerebellar Ataxia: Neurological sequelae of Malaria in an Adolescent Girl
Acta Scientific Medical Sciences, 2021
Background: Malaria remains a serious infectious disease causing a high rate of morbidity and mortality. Whereas cerebral malaria and other neurological sequelae have been described among under-fives and adults, a case of delayed cerebellar ataxia has not been published among adolescents in Uganda. Case Presentation: A 10-year-old, HIV-negative girl who initially presented with severe headache and new-onset seizures, who developed severe cerebellar ataxia and vertigo on Day 14 after treatment. Notably, she had no other risk factors for cerebellar ataxia and had a normal cerebrospinal fluid and a normal CT-scan report. She was treated with anti-malarial medication, anti-convulsant therapy and antihistamines. She was discharged home in a stable condition. Conclusion: We describe a case of delayed cerebellar ataxia in a 10 year-old HIV negative adolescent girl after completing her course of anti-malarial treatment. This case highlights the need of immediate follow-up of adolescents with cerebral malaria since they may present with delayed cerebellar ataxia.
An Unusual Etiology of Cerebellar Ataxia
Child Neurology Open, 2020
Cerebellar ataxia, which is the lack of coordination, has a number of causes none of which are as uncommon or unheard of as Scrub typhus. Scrub typhus very rarely presents itself with CNS manifestations. Here, we present the case of a 7-year-old girl from the Hooghly district in West Bengal, who presented to us with the history of fever, cerebellar signs, and sudden onset of visual loss. She was ultimately diagnosed with scrub typhus cerebellitis.
Plasmodium falciparum malaria, bilateral sixth cranial nerve palsy and delayed cerebellar ataxia
The Journal of Infection in Developing Countries, 2012
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.
Population-based study of acquired cerebellar ataxia in Al-Kharga district, New Valley, Egypt
Neuropsychiatric …, 2011
Background:The aim of this research was to determine the prevalence and etiology of acquired ataxia in Al-Kharga district, New Valley, Egypt.Methods:A population-based study of acquired ataxia was conducted in a defined geographical region with a total population of 62,583. A door-to-door survey was used to identify cases of acquired cerebellar ataxia. Patients with acquired cerebellar ataxia at any age and of both genders were included. Cases of known inherited cerebellar ataxia, acquired neurological disorders with ataxia as a minor feature, or pure acquired sensory ataxia, were excluded.Results:We identified 17 cases of acquired ataxia, of which eight were vascular, six were an ataxic cerebral palsy subtype, and three involved postencephalitic ataxia. The crude prevalence rate for acquired ataxia was 27.16/100,000 (95% confidence interval [CI]: 14.3–40.1). The mean age of the patients at interview was 31.8 (range 4–72) years, with a male to female ratio of 2.1:1. The most frequent presenting complaint was disturbance of gait (90.7%). The majority (92%) were ambulatory, but only 9.3% were independently self-caring.Conclusion:This population-based study provides an insight into acquired cerebellar ataxia within a defined region, and may inform decisions about the rational use of health care resources for patients with acquired cerebellar ataxia. The most common causes of acquired cerebellar ataxia in this region were cerebrovascular injury and cerebral palsy.
Journal of Child Neurology, 2020
Acute cerebellitis is a rare condition often considered within the group of acute postinfectious cerebellar ataxia despite its distinctive clinical and imaging features. We retrieved clinical, laboratory, and follow-up data of 15 children diagnosed with acute cerebellitis in our department between 2011 and 2019. There were 10 boys and 5 girls aged 3-15 years, median 9.5 years. The most common first symptoms were ataxia, vomiting, and headache. Magnetic resonance imaging (MRI) generally showed bilateral symmetrical T2 hyperintense changes with moderate swelling in the cerebellar cortex. Tonsillar herniation was present in 73.3% and obstructive hydrocephalus in 26.6%. Etiologic workup for infectious pathogens revealed Mycoplasma pneumoniae, influenza A virus, cytomegalovirus, and varicella zoster virus in 1 case each. Fourteen of 15 patients were treated with intravenous and/or oral steroids and 8 cases with intravenous immunoglobulin. No patient required surgical decompression. Neurologic examination median 12 months later revealed ataxia and dysmetria in 4 cases (27%), accompanied by memory difficulties, dysarthria or tremor. Follow-up magnetic resonance imaging (MRI; n ¼ 12) showed diffuse cerebellar cortical T2-hyperintense signal changes in 11 cases and cerebellar atrophy in 9. The diagnosis of acute cerebellitis rather than acute postinfectious cerebellar ataxia should be considered when headache and vomiting accompany ataxia in a child. Acute cerebellitis heals with sequelae in about one-third of cases. The absence of fatalities in our series suggests early diagnosis, and steroid treatment can increase the chance of recovery. MRI results were not found to be predictive of outcome.
Essentials of Cerebellum and Cerebellar Disorders
2016
the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.
Epidemiology of Cerebellar Ataxia in Al-Kharga District-New Valley (Egypt)
2010
Background: Rare comprehensive epidemiological studies of ataxia have been undertaken worldwide. Objective: To estimate the prevalence of cerebellar ataxia and its subtypes in Al-Kharga District - New Valley. Methods: This is a community based study carried out through three stages. Total populations 62,583 were screened door to door (every door) by three specialists of neurology. All suspected patients were subjected to complete medical, neurological examination and brain MRI. Results: Twenty four patients of Cerebellar ataxia were recorded in this study with prevalence rate PR 38.34/100,000(95%CI; 23.01-53.69). The order of frequency of different types of cerebellar ataxia was as follows; 8 patients had vascular cerebellar ataxia (PR: 12.8/100000; 95%CI: 3.93 - 21.64), 6 patients had ataxic cerebral palsy (PR: 9.6/100,000; 95%CI: 1.92 - 17.26), 5 patients had unclassified progressive cerebellar ataxia (PR: 8/100,000; 95%CI: 0.99-14.99), 3 patients had post encephalitic ataxia (PR:...