Clinical and electrophysiological assessment of cerebral malaria

From January 1980 to December 1990, six cases of malaria were observed; three cases were caused by plasmodium (P.) vivax and three by P. falciparum. Following a malaria episode, two cases (33.3%), developed cerebral malaria. Both of them were infected by P. falciparum. Neurological and electrodiagnostic investigations were scheduled throughout their clinical course. The first case manifested as a grand mal seizure, followed by myoclonic jerk and a comatous state. A suppression burst EEG observed before anti-malarial therapy was initiated. In the second case, a manifestation of encephalo-myelo-neuropathy was confirmed clinically and electrophysiologically. Although both cases occurred suddenly and were extremely severe, early anti-malarial therapy resulted in good responses without sequelae. The complete reversibility of the pathological event depends on early recognition and comprehensive therapy. Further, electrophysiological assessment is recommended for the detection of regional involvement in cerebral malaria.