Ozen Metehan, Gungor Serdal, Atambay Metin, Daldal Nilgün
Department of Paediatrics, Faculty of Medicine, Inonu University, Malatya, Turkey.
Ann Trop Paediatr. 2006 Jun;26(2):141-4. doi: 10.1179/146532806X107494.
Cerebral malaria is a diffuse encephalopathy associated with seizures and status epilepticus which can occur in up to one-third of children with severe malaria, particularly that caused by Plasmodium falciparum. We report a unique case of P. vivax infection complicated by status epilepticus. A 4-year-old boy was admitted to the emergency outpatient clinic with intractable seizures for the previous hour. During resuscitation, two episodes of left-focal tonic convulsions occurred and he received phenytoin. Because of a history of P. vivax infection in the family 3 months previously, a blood slide for malaria was undertaken. Thin blood smears demonstrated P. vivax. He was treated with chloroquine and primaquine. An initial EEG was normal but after 3 months of follow-up a second EEG showed generalised epileptic activity. Rarely, cerebral malaria is a presenting complication or occurs during the course of P. vivax infection. In endemic areas such as Turkey, the possibility of cerebral malaria should be considered.
脑型疟疾是一种与癫痫发作和癫痫持续状态相关的弥漫性脑病,在高达三分之一的重症疟疾儿童中可能发生,尤其是由恶性疟原虫引起的。我们报告了一例间日疟原虫感染并发癫痫持续状态的独特病例。一名4岁男孩因前一小时的顽固性癫痫发作被收治入急诊门诊。在复苏过程中,发生了两次左侧局灶性强直惊厥,他接受了苯妥英治疗。由于3个月前家中有间日疟原虫感染史,遂进行了疟疾血涂片检查。薄血涂片显示为间日疟原虫。他接受了氯喹和伯氨喹治疗。初始脑电图正常,但随访3个月后第二次脑电图显示有全身性癫痫活动。脑型疟疾很少作为首发并发症出现或在间日疟原虫感染过程中发生。在土耳其等流行地区,应考虑脑型疟疾的可能性。