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Evoked potentials in pediatric cerebral malaria
Minal Bhanushali1, Terrie E Taylor, Malcolm E Molyneux
1US National Institute of Health, 10-CRC Hatfield Research Center, Bethesda, USA;
Insights
Cortical evoked potentials (EPs) in children with cerebral malaria (CM) were generally intact and did not predict long-term neurological issues. Further research is needed to see if EPs can predict fatal outcomes in CM.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Infectious Diseases
Background:
- Cerebral malaria (CM) is a severe neurological complication of malaria.
- Cortical evoked potentials (EPs) offer insights into brain function and potential prognostic value in neurological injuries.
- Understanding CM's impact on brain function is crucial for predicting outcomes.
Purpose of the Study:
- To evaluate the prognostic value of cortical evoked potentials (EPs) in pediatric cerebral malaria (CM).
- To assess the relationship between EPs and long-term neurological sequelae in children with CM.
- To investigate the utility of EPs in predicting outcomes in pediatric CM.
Main Methods:
- A prospective cohort study involving 27 pediatric patients admitted with CM.
- Somatosensory evoked potentials (SSEPs) and brainstem auditory EPs (AEPs) were recorded within 24 hours of admission.
- Children were followed for 12 months to assess for adverse neurological outcomes.
Main Results:
- Cortical EPs were generally intact in pediatric CM survivors and did not predict adverse neurological outcomes.
- Only one subject with absent cortical EPs at admission had a good neurological outcome.
- Among 25 survivors followed for an average of 514 days, 28.0% experienced at least one adverse neurological outcome.
Conclusions:
- In pediatric CM survivors, intact cortical EPs do not appear to predict adverse neurological outcomes.
- Further investigation is required to determine if altered cortical EPs can predict mortality in CM.
- Evoked potentials may offer insights but require further validation for prognostic use in pediatric CM.
Abstract:
Cortical evoked potentials (EP) provide localized data regarding brain function and may offer prognostic information and insights into the pathologic mechanisms of malaria-mediated cerebral injury. As part of a prospective cohort study, we obtained somatosensory evoked potentials (SSEPs) and brainstem auditory EPs (AEPs) within 24 hours of admission on 27 consecutive children admitted with cerebral malaria (CM). Children underwent follow-up for 12 months to determine if they had any long term neurologic sequelae. EPs were obtained in 27 pediatric CM admissions. Two children died. Among survivors followed an average of 514 days, 7/25 (28.0%) had at least one adverse neurologic outcome. Only a single subject had absent cortical EPs on admission and this child had a good neurologic outcome. Among pediatric CM survivors, cortical EPs are generally intact and do not predict adverse neurologic outcomes. Further study is needed to determine if alterations in cortical EPs can be used to predict a fatal outcome in CM.
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