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Journal of Tropical Pediatrics 1993 39(6):350-355; doi:10.1093/tropej/39.6.350
© 1993 by Oxford University Press
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Convulsions with Malaria: Febrile or Indicative of Cerebral Involvement?

G. O. Akpede, FWACP, FMC Paed (Nig)*,, R. M. Sykes, MRCP (UK), DCH** and P. O. Abiodun, FAF Paed (Giessen), FWACP***

* Department of Child Health, University of Benin Teaching Hospital Benin City, Nigeria
** Institute of Child Health, College of Medical Sciences, University of Benin Benin City, Nigeria
*** Department of Child Health, College of Medical Sciences, University of Benin Benin City, Nigeria

Correspondence: Dr G. O. Akpede, Department of Paediatrics, College of Medical Sciences, University of Maiduguri. PMB 1069, Maiduguri, Borno State, Nigeria

Evaluation of 446 infants and young children (6 months to 5 years olds) with malaria parasitaemia showed a significant relationship (P<0.O5–<0.001) (a) between coma and age, pattern of convulsions, haematocrit, and blood glucose, and (b) between the severity of parasitaemia and risk of convulsions, prevalence of hepatosplenomegaly, and severe anaemia. No significant relationship was observed between convulsions and temperature or haematocrit. Comatose children were older and had a higher prevalence of repeated convulsions, severe anaemia, and hypoglycaemia than non-comatose children. Convulsions, hepatosplenomegaly, and severe anaemia were more prevalent in children with moderate-severe parasitaemia. It is concluded that convulsions with malaria are more often a manifestation of cerebral dysfunction rather than being simply febrile in nature. All forms of cerebral dysfunction in malaria, including repeated convulsions, should be managed as being clinical manifestations of cerebral malaria.


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