Case Presentation of Epilepsy Secondary to Cerebral Malaria

Abstract

Epilepsy is the most common neurological disease in Uganda in both children and adults with a the prevalence of 2–5/1,000 of the general population and as high as 70 % in onchocerciasis volvulus affected populations. The causes are multiple but in the Ugandan and other African settings, the most common causes are usually infections in childhood (cerebral malaria, HIV etc.), birth trauma, brain injury in adulthood and substance abuse. Cerebral malaria, characterised by high fever, convulsions and /or coma is one of the deadliest forms of malaria and is caused by the Plasmodium falciparum malaria haemoparasite.

Epilepsy is a common sequel of cerebral malaria in highly endemic areas as is the case in most sub-Saharan African regions and it occurs mostly in children. It is postulated that red blood cells infected with malaria parasites sequestrate and clog brain capillaries which appear as petechial haemorrhages in the brain causing brain hypoxia and edema leading to convulsions and coma. Children with cerebral malaria are at risk of developing several adverse neurological outcomes including epilepsy, disruptive behaviour disorders (e.g. ADHD) and disabilities characterised by motor, sensory or language and learning deficits. These affect approximately 10 % of survivors of cerebral malaria and represent a form of injury to the brain or brain degeneration pointing. Epilepsy is highly stigmatised in Africa pointing to a need to educate the people and increase public awareness about epilepsy facts to demystify the disease so that the sufferers are not treated as outcasts and not to be stigmatized. This is in addition to malaria eradication programs.

Keywords

Cerebral malaria Epilepsy Convulsions Coma Brain damage Stigma Prevention 

Abbreviations

HIV

Human Immunodeficiency Virus

MHC

Mental Health Clinic

SVD

Spontaneous Vertex Delivery

EEG

Electroencephalogram

RBS

Random Blood Sugar

WBC

White Blood Cells

FBC

Full Blood Count

FBS

Fasting Blood Sugar

Hb

Hemoglobin

CM

Cerebral Malaria

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of PsychiatryMakerere University College of Health SciencesKampalaUganda

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