Cerebral malaria

Cerebral malaria may be the most common non-traumatic encephalopathy in the world. The pathogenesis is heterogenous and the neurological complications are often part of a multisystem dysfunction. The clinical presentation and pathophysiology differs between adults and children. Recent studies have e lucidated the molecular mechanisms of pathogenesis and raised possible inte rventions. Antimalarial drugs, however, remain the only intervention that u nequivocally affects outcome, although increasing resistance to the establi shed antimalarial drugs is of grave concern. Artemisinin derivatives have m ade an impact on treatment, but other drugs may be required. With appropria te antimalarial drugs, the prognosis of cerebral malaria often depends on t he management of other complications-for example, renal failure and acidosi s. Neurological sequelae are increasingly recognised, but further research on the pathogenesis of coma and neurological damage is required to develop other ancillary treatments.