How to identify Psychological disorder associated with Malaria could involve a great doing.
Malaria is one of the most common ailment in African and Cerebral Malaria is the worst case of malaria that may lead to death. Statistics has it that 85% motilities caused by malaria are connected to CNS.
The manifestation of CNS in malaria are moderately common and this is as a result of a very high fever, acute P. Falciparum infection and anti-malaria drugs.
In other to manage this, it is advisable to differentiate between them so to avoid prescribing the wrong treatment. In this article, ukrido.com will guide you on how to identify Cerebral malaria in patients.
How to Identify Cerebral Malaria
Cerebral Malaria could be present if the patient shows symptoms like:
Delirium; Focal and generalised convulsions; a normal neurological signs; any degree of impaired consciousness.
Woman with Cerebral Malaria
In acute P. Falciparum Malaria, the manifestation of neurological dysfunction could be a gradual process for some hours and at the other hand, it could manifest rapidly following a generalised seizure.
Causes of neurological manifestations in malaria
In children, febrile convulsions and Psychosis while in adult, a very high fever can result to impairment of consciousness.
To manage this, you have to seek for ways to reduce the body temperature so to bring down the situation. Cases with unimpaired consciousness after seizures tend to maintain a good prognosis.
Most anti-malaria drugs such as Quinine, Mefloquine, Chloroquine and Halofantrine could be linked to the manifestation of convulsions, Hallucinations, Altered behaviour and Psychosis. This can only occur when the case is with high fever and P. Falciparum.
Hypoglycaemia
This is another cause of neurological manifestation. Hypoglycaemia is common in pregnant women and in elderly people, it is usually caused by repeated vomiting. It may manifest as a result of quinine or acute malaria. In cases like these, it is imperative to administer 25-50% intravenous dextrose.
Cases with acute Anaemia and Hypoxemia can equally result to cerebral dysfunction, especially in children.
Other causes of neurological dysfunction associated with malaria are;
Neck rigidity, Focal neurological deficits, photophobia, paplloedema and neurological sequelae.
Neurological signs in cerebral malaria:
1. Inability to respond to Noxious Stimuli.
2. Neck Stiffness.
3. Coma.
4. Dysonjugate gaze.
5. Bruxism (Jaw closure and grinding of teeth).
6. Pouting.
7. Corneal reflexes.
8. Decorticate rigidity.
9. Opisthotonus.
Management
1. In cases associated with prolonged deep coma, it is advisable to maintain a clear airway for the patient.
2. Changing patient’s bedding position every 2 hours to avoid soiled and wet beds.
3. Patients under coma should be kept in a semi-recumbent position to minimize the risk for aspiration.
4. Check on the patient’s vital science at an interval of 5-6 hours.
5. Monitor the patient for black or deep colored urine. To do this, catheter should be inserted for observations.
6. Use anticonvulsants on patient immediately should Seizures occur.
7. Abstain from using Manitol, low molecular weight dextran, urea, invert sugar, adrenaline, pentoxifylline, ciclosporin, hyperbaric oxygen, heparin etc.
Treatment for Cerebral Malaria
Parenteral Quinine can be use to treat cerebral malaria and Artemisinin could go along way to give a good result.
