Cerebral malaria presenting as nonconvulsive status epilepticus: a case report

作者全名："Wu, Xingguo; Qin, Ningxiang; Yi, Fahang; Wang, Jing; Yan, Xia; Wang, Liang"

作者地址："[Wu, Xingguo; Qin, Ningxiang; Yi, Fahang; Wang, Jing; Yan, Xia; Wang, Liang] Chongqing Med Univ, Affiliated Hosp 1, Dept Neurol, Chongqing, Peoples R China; [Wu, Xingguo] Jinsha Cty Peoples Hosp, Bijie, Guizhou, Peoples R China"

通信作者："Wang, L (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Neurol, Chongqing, Peoples R China."

来源：MALARIA JOURNAL

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001187378100003

JCR分区：Q2

影响因子：2.4

年份：2024

卷号：23

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Cerebral malaria; Nonconvulsive status epilepticus; Electroencephalogram

摘要："BackgroundMalaria is an infectious malady caused by Plasmodium parasites, cerebral malaria standing out as one of its most severe complications. Clinical manifestation include elevated body temperature, loss of consciousness, and seizures. However, reports of cerebral malaria presenting as nonconvulsive status epilepticus are extremely rare. The case presented involves psychiatric symptoms, with the electroencephalogram indicated nonconvulsive status epilepticus associated with cerebral malaria.Case presentationA 53-year-old male, was urgently admitted, due to confusion and abnormal behaviour for 10 h. The patient returned to China after developing a fever while working in Tanzania two months ago. The blood smear revealed Plasmodium vivax and Plasmodium falciparum, and he was diagnosed with malaria. He recovered following anti-malarial treatment. After admission, the patient was confused, unable to communicate normally, and unwilling to cooperate with the physical examination. Plasmodium was not found in the blood smear, but the DNA sequence of P. falciparum was discovered using metagenomic next-generation sequencing of cerebrospinal fluid. Brain MRI revealed no significant abnormalities. Continuous electroencephalogram monitoring revealed that the patient had non-convulsive status epilepticus, which was treated with diazepam and levetiracetam. The patient had normal consciousness and behaviour. He received anti-malarial treatment for two weeks and fully recovered.ConclusionsThis case demonstrates that nonconvulsive status epilepticus can be a manifestation of cerebral malaria. It is imperative for attending physicians to heighten vigilance when encountering patients with a history of travel to malaria-endemic regions or a prior malaria infection, especially in the presence of unusual clinical presentations."

基金机构：Joint Medical Research Project of Chongqing Science & Technology and Health Commission

基金资助正文：Not applicable.