Consultant Neurologist, National Center of Neurological Sciences, Khartoum, Sudan.
Associate Professor of Neurology, Department of Neurology, Faculty of Medicine, Al-Neelain University, Khartoum, Sudan.
BMC Pediatr. 2022 May 12;22(1):265. doi: 10.1186/s12887-022-03313-2.
In South Sudan, sleeping sickness is a frequent condition caused by human African trypanosomiasis. There are two stages that are well-known. When the CNS is affected, especially with Trypanosoma gambiense infection, the early hemolymphatic stage and the late encephalitic stage have been observed, including mental, motor, and sensory symptoms. In this case, second-stage African trypanosomiasis manifested itself in an atypical neurological manner.
A 16-year-old boy from South Sudan referred to Sudan National Centre for Neurological Sciences, Khartoum, Sudan suffering from non-convulsive status epilepticus, mental deterioration and behavioral changes for the last nine months. He was conscious but disorientated. Low hemoglobin concentration, elevated ESR, enlarged spleen and positive card agglutination test for trypanosomiasis was found in this patient. Electro-encephalogram (EEG) found an on-going generalized seizure activity. The patient showed improvement after management with carbamazepine and tonic.
Our case highlights that late second stage African trypanosomiasis with neurological complications such as non-convulsive status epilepticus should be suspected in any patient who developed progressive cognitive decline and behavioral changes following long standing history of African Trypanosomiasis and routine Electro-encephalogram EEG is the best tool to diagnose non convulsive status epilepticus.
在南苏丹，昏睡病是一种由人体非洲锥虫病引起的常见疾病。有两个阶段是众所周知的。当中枢神经系统受到影响时，特别是感染了冈比亚锥虫时，已经观察到早期的血液淋巴期和晚期的脑炎期，包括精神、运动和感觉症状。在这种情况下，二期非洲锥虫病以非典型的神经方式表现出来。
一名来自南苏丹的 16 岁男孩，因非惊厥性癫痫持续状态、精神恶化和行为改变，在过去九个月中来到苏丹国家神经科学中心，喀土穆，苏丹。他意识清醒但定向力差。该患者发现低血红蛋白浓度、血沉升高、脾脏肿大和锥虫病阳性胶乳凝集试验。脑电图（EEG）发现持续的全面性癫痫活动。在使用卡马西平和强直治疗后，患者病情得到改善。
我们的病例强调，任何患有非洲锥虫病病史较长、认知功能逐渐下降和行为改变的患者，如果出现非惊厥性癫痫持续状态等神经并发症，应怀疑为晚期二期非洲锥虫病，常规脑电图 EEG 是诊断非惊厥性癫痫持续状态的最佳工具。
