Idro et al evaluated children following cerebral malaria for evidence of persistent neurological and cognitive impairments. They identified risk factors which can be used to identify children who may benefit from followup. The authors are from the Centre for Geographic Medicine Research and Wellcome Trust Research Labs in Kenya.
Impairments:
(1) motor
(2) speech and language
(3) other cognitive functions
Risk Factor |
Motor |
Speech/Language |
Other Cognitive |
previous admissions |
yes |
|
|
focal neurological signs |
yes |
|
|
multiple seizures (>= 3) with cerebral malaria |
yes |
|
|
age < 3 years |
|
yes |
|
previous history of seizures |
|
yes |
yes |
raised intracranial pressure |
|
yes |
|
severe malnutrition |
|
yes |
|
hypoglycemia on admission |
|
yes |
|
deep coma on admission |
|
|
yes |
prolonged coma after admission |
|
yes |
yes |
neurological deficits on discharge |
|
yes |
|
where:
• Raised intracranial pressure is based on brain stem and fundoscopic evidence.
• Severe malnutrition was based on the weight for age z score.
• Impaired attention was associated with deep coma and severe malnutrition.
• Memory impairment was associated with absence of a history of fever, deep coma and prolonged coma after admission.
• Non-verbal functioning was associated with hypoglycemia.
Specialty: Infectious Diseases