Post Malaria Neurological Syndrome: Unknown, Underestimated, or Underdiagnosed? First Report Done in Gambia

Abstract

Post-malaria neurological syndrome (PMNS) is a rare self-limiting neurological complication that can occur after recovery from malaria, usually severe falciparum malaria. It is characterized by a myriad of neuropsychiatric manifestations including mild neurological deficit to severe encephalopathy. PMNS is a debated entity, is a rare complication of severe malaria that might be underreported. It can develop up to 2 months after clearance of parasitemia. Clinical features can be variable. Most cases are self-limited, but more severe cases may benefit from steroid therapy. There are several neurological syndromes that can occur following complete recovery from malaria, in particular Plasmodium falciparum. These PMNS include, delayed cerebellar ataxia (DCA), acute inflammatory demyelinating polyneuropathy (AIDP) and acute disseminated encephalomyelitis (ADEM). In 2021 according to WHO report, the African region was home to 95% of all malaria cases and 96% of deaths. Paradoxically, reports of post malaria neurological syndrome in west Africa sub region are practically null, it is not clear if it is due to lack of knowledge regarding the disease, underdiagnosis or combination of factors, the first case of post malaria neurological syndrome in Gambia is described below. The objective is to show that cases exist, but due to lack of knowledge by health personnel they are overwhelmingly underdiagnosed.