Clinical features:
(1) usually affects a nonimmune adult
(2) history of severe falciparum malaria
(3) onset 4 to 60 days after recovery from malaria, often with fever
(4) features of diffuse encephalopathy with 1 or more of the following:
(4a) impaired consciousness and/or confusion
(4b) aphasia
(4c) seizure activity
(4d) tremor
(4e) psychosis
(4f) ataxia
(4g) myoclonus
(5) self-limited course lasting 2 to 14 days
(6) lymphocytosis in the CSF
(7) EEG consistent with encephalopathy
(8) exclusion of other conditions
Patients recover without specific therapy. Treatment with corticosteroids is associated with rapid clinical recovery.
Differential diagnosis:
(1) persistent cerebral malaria
(2) delayed onset cerebellar ataxia (DCA)
(3) acute disseminated encephalopathy (ADEM)
(4) acute inflammatory demyelinating polyneuropathy (AIDP, Guillain-Barre)
