title: Epilepsy as a consequence of cerebral malaria in area in which malaria is endemic in Mali, West Africa.
abstract: OBJECTIVE
  Cerebral malaria (CM) is suspected to be a potential cause of epilepsy in tropical areas, but little information is available. The purpose of this study was to evaluate the role of CM in epilepsy among children in Mali.
  
  
  METHODS
  An exposed-nonexposed study was performed to identify children who had epilepsy after malaria in the 0- to 15-year age group. The exposure factor was CM defined according to World Health Organization (WHO) criteria, and the nonexposure factor was symptomatic malaria without the characteristics of CM (NCM). All the children underwent a screening questionnaire and were examined by a medical physician. After the screening phase, a specialist in neuropediatrics examined the children suspected to have epilepsy. EEG and computed tomography (CT) scans were performed in some of these patients.
  
  
  RESULTS
  In total, 101 subjects who had had CM and 222 who had had NCM were included. Fifty-four children (CM, 34; NCM, 20) were suspected to have epilepsy, and six were confirmed (CM, five; NCM, one). The incidence rate was 17.0 per 1000 person-years in the CM group and 1.8 per 1000 person-year in the NCM group; thus the relative risk (RR) was 9.4 [95% confidence interval (CI), 1.3-80.3; p = 0.02]. After adjustment on age and duration of follow-up, the RR was 14.3 (95% CI, 1.6-132.0; p = 0.01).
  
  
  CONCLUSIONS
  The risk of sequelar epilepsy is significantly higher in the CM group compared with the NCM group. A reevaluation of this cohort should be carried out later to search for temporal epilepsy that appeared after age 10 years.
authors: Institute of Neuroepidemiology and Tropical Neurology EA 3174, Faculty of Medicine, Limoges, France.
authors: Edgard Brice
authors: EB
authors: Ngoungou
authors: Olivier
authors: O
authors: Dulac
authors: Belco
authors: B
authors: Poudiougou
authors: Michel
authors: M
authors: Druet-Cabanac
authors: Alassane
authors: A
authors: Dicko
authors: Abdoulaye
authors: A
authors: Mamadou Traore
authors: Drissa
authors: D
authors: Coulibaly
authors: Guy
authors: G
authors: Farnarier
authors: Maryse
authors: M
authors: Tuillas
authors: Marouf Mamadou
authors: MM
authors: Keita
authors: Maryvonne
authors: M
authors: Kombila
authors: Ogobara K
authors: OK
authors: Doumbo
authors: Pierre-Marie
authors: PM
authors: Preux