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Lancet. 2000 Feb 26;355(9205):671-2.

Impact of malaria on the brain and its prevention.

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Wellcome Trust Research Laboratories, College of Medicine, University of Malawi, Blantyre.



This article focuses on the impact of malaria on the brain and its prevention. The two studies conducted in Africa observing the gross neurological sequelae of cerebral malaria have identified features of the original illness that are predictive of later cerebral impairment. Among these factors, depth of coma and repeated or prolonged seizures have emerged in almost all studies as being prognostically important. In view of these findings, a study was conducted on the effective measure for the prevention of seizures in children with cerebral malaria. The study recorded that the children given 20 mg/kg of phenobarbital had significantly fewer seizures and neurological sequelae than the children given a placebo. However, such a measure was noted to have potentially disastrous consequences; a significantly higher mortality rate in the phenobarbital group was recorded compared to the rate in the placebo group. Hence, further studies are still needed to guide the use of anticonvulsants in cerebral malaria.

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