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.
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