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Overview :
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 stum 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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