García-Peñas J J, Quintero V, Gutiérrez-Solana L G, Ruiz-Falcó M L
Sección de Neurología-2, Hospital Niño Jesús, Madrid, España.
Rev Neurol. 2000;30(1):15-20.
Malaria is one of the main health problems in the Third World. Plasmodium falciparum infects as many as 300 million people, causing up to three million deaths each year, most of which occur in African children. Cerebral malaria is the most common lethal complication of P. falciparum infection in children and is defined by three criteria: disturbances of consciousness, presence of P. falciparum parasitaemia and absence of other causes of acute encephalopathy. Cerebral malaria is a medical emergency and parenteral quinine is the most recommended treatment because of the frequency of chloroquine-resistant strains. Mortality is as high as 50 per cent and residual disability is present in about 20 per cent of survivors.
We want to warm Spaniard neuropaediatricians about the existence of cases of cerebral malaria in our country in order to get a better diagnose and treatment for those children.
A retrospective medical scores review of 20 hospitalised children diagnosed of malaria from 1990 to 1998. We selected three cases with neurological signs and we analysed clinical onset, EEG, neuroimaging, and permanent sequels.
All patients had acute encephalopathy with fever, obtundation and seizures. They all presented residual disability (mainly hemiparesis).
We must know better about cerebral malaria because of an increasing incidence of imported malaria due to emigration from African countries and Spaniard tourism to areas of endemic paludism.
疟疾是第三世界主要的健康问题之一。恶性疟原虫感染多达3亿人，每年导致多达300万人死亡，其中大多数发生在非洲儿童身上。脑型疟疾是儿童恶性疟原虫感染最常见的致命并发症，由三个标准定义：意识障碍、恶性疟原虫血症的存在以及无其他急性脑病病因。脑型疟疾是一种医疗急症，由于耐氯喹菌株的出现频率，肠外奎宁是最推荐的治疗方法。死亡率高达50%，约20%的幸存者存在残留残疾。
我们想提醒西班牙神经儿科医生注意我国存在脑型疟疾病例，以便为这些儿童提供更好的诊断和治疗。
对1990年至1998年期间20例住院诊断为疟疾的儿童进行回顾性医学评分审查。我们选择了3例有神经体征的病例，并分析了临床发病、脑电图、神经影像学和永久性后遗症。
所有患者均有急性脑病，伴有发热、意识模糊和癫痫发作。他们都存在残留残疾（主要是偏瘫）。
由于从非洲国家移民以及西班牙人前往疟疾流行地区旅游导致输入性疟疾发病率上升，我们必须更好地了解脑型疟疾。
