Issue: 2005 > May > case report

Neurological complications following <i>Plasmodium falciparum</i> infection

G. van der Wal, W.I.M. Verhagen, A.S.M. Dofferhoff


Several neurological complications are associated with
severe falciparum malaria. Cerebral malaria is one of the most life-threatening complications. A few patients may experience a neurological syndrome after complete recovery from <i>Plasmodium falciparum</i> infection. In the literature especially the postmalaria neurological syndrome (PMNS), acute disseminated encephalomyelitis (ADEM) and delayed cerebellar ataxia have been reported.
We describe a case of a 53-year-old woman who was readmitted after an adequately treated <i>P. falciparum</i> infection with word-finding difficulties, confusion and tremor. Peripheral blood smears were repeatedly negative for malarial parasites. The clinical features best fitted a PMNS. Because of the severity of the syndrome she was treated with high-dose prednisone. She recovered completely. The possibility of ADEM is also discussed. Aetiology of these syndromes is still unknown, but it could be mediated by an immunological mechanism. PMNS or ADEM must be considered when neurological signs andsymptoms occur after recovery from a <i>P. falciparum</i> infection.