Post-Malaria Neurological Syndrome - A Case of Bell’s Palsy After Plasmodium Vivax Malaria

Ak Singh,S Chakraborti,S Subhranag

doi:10.3126/jnps.v33i1.6893

Abstract

Post-malaria neurological syndrome (PMNS) is defined as the acute onset of neurological or neuropsychiatric syndrome in a patient who had recently recovered from malaria and have negative blood film at the time of onset of neurological symptoms. It is relatively rare, with various clinical symptoms. We report first case of Bell’s palsy developing on 10th day of afebrile period after successful treatment of Plasmodium vivax (P.vivax) malaria and which completely recovered in next two weeks. DOI: http://dx.doi.org/10.3126/jnps.v33i1.6893 J Nepal Paediatr Soc. 2013;33(1):66-67

Highlights

Post-malaria neurological syndrome (PMNS) is usually a short-lived, self-limiting condition with no long-term neurological sequelae
PMNS is defined as the acute onset of confusion, epileptic seizures, or any other neurological or psychiatric sign occurring with a latency of several days to weeks after an episode of successfully treated P. falciparum malaria[1]
It generally follows after infection with P. falciparum but few case reports of PMNS after P.vivax malaria are available in literature, one case presented with acute disseminated encephalomyelitis like picture, second one with acute inflammatory demyelinating polyneuropathy and third with bilateral facial nerve palsy[4]

Summary

Introduction

PMNS is usually a short-lived, self-limiting condition with no long-term neurological sequelae. Clinical spectrum include generalised convulsions, acute confusional state, psychosis, tremors, cerebellar ataxia, motor aphasia, generalised myoclonus, bilateral facial nerve palsy[2,3,4]. It generally follows after recovery from Plasmodium falciparum (P.falciparum) malaria. A six year old male was admitted in Paediatrics department with complaints of fever for 6 days, with headache. During physical examination, he was conscious, oriented and there was mild pallor but no icterus, lymphadenopathy or cyanosis. After 10 days of discharge patient presented with complaints of sudden onset of weakness in right side of face, difficulty in closing his right eyelid, deviation

Discussion

Conclusion