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Reference: Idro, R, Otieno, G, White, S et al., (2005). Decorticate, decerebrate and opisthotonic posturing and seizures in Kenyan children with cerebral malaria. Malaria Journal, 4, Article: 57.Citable link to this page:

 

Decorticate, decerebrate and opisthotonic posturing and seizures in Kenyan children with cerebral malaria.

Abstract: BACKGROUND: Abnormal motor posturing is often observed in children with cerebral malaria, but the aetiology and pathogenesis is poorly understood. This study examined the risk factors and outcome of posturing in Kenyan children with cerebral malaria. METHODS: Records of children admitted to Kilifi district hospital with cerebral malaria from January, 1999 through December, 2001 were reviewed for posturing occurring on or after admission. The clinical characteristics, features of raised intracranial pressure, number of seizures and biochemical changes in patients that developed posturing was compared to patients who did not. RESULTS: Of the 417 children with complete records, 163 (39.1%) had posturing: 85 on admission and 78 after admission to hospital. Decorticate posturing occurred in 80, decerebrate in 61 and opisthotonic posturing in 22 patients. Posturing was associated with age > or = 3 years (48.1 vs 35.8%, p = 0.01) and features of raised intracranial pressure on funduscopy (adjusted OR 2.1 95%CI 1.2-3.7, p = 0.009) but not other markers of severity of disease. Unlike decorticate posturing, decerebrate (adjusted OR 1.9 95%CI 1.0-3.5) and opisthotonic posturing (adjusted OR 2.9 95%CI 1.0-8.1) were, in addition, independently associated with recurrence of seizures after admission. Opisthotonus was also associated with severe metabolic acidosis (OR 4.2 95%CI 3.2-5.6, p < 0.001). Thirty one patients with posturing died. Of these, 19 (61.3%) had features suggestive of transtentorial herniation. Mortality and neurological deficits on discharge were greatest in those developing posturing after admission. CONCLUSION: Abnormal motor posturing is a common feature of cerebral malaria in children. It is associated with features of raised intracranial pressure and recurrence of seizures, although intracranial hypertension may be the primary cause.

Peer Review status:Peer reviewedPublication status:PublishedVersion:Publisher's versionNotes:© 2005 Idro et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Bibliographic Details

Publisher: BioMed Central Ltd.

Publisher Website: http://www.biomedcentral.com/

Journal: Malaria Journalsee more from them

Publication Website: http://www.malariajournal.com/

Issue Date: 2005

pages:Article: 57Identifiers

Urn: uuid:c2303ff8-d7ac-4053-8a2d-1e6ea0d40188

Source identifier: 185636

Eissn: 1475-2875

Doi: https://doi.org/10.1186/1475-2875-4-57

Issn: 1475-2875 Item Description

Type: Journal article;

Language: eng

Version: Publisher's versionKeywords: Humans Brain Stem Malaria, Cerebral Seizures Intracranial Hypertension Decerebrate State Coma Retrospective Studies Child, Preschool Infant Logistic Models Time Factors Kenya Risk Factors Female Male Tiny URL: pubs:185636

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Author: Idro, R - - - Otieno, G - - - White, S - - - Kahindi, A - - - Fegan, G - - - Ogutu, B - - - Mithwani, S - - - Maitland, K - - - N

Source: https://ora.ox.ac.uk/objects/uuid:c2303ff8-d7ac-4053-8a2d-1e6ea0d40188



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