A Cerebral Malaria Simulating an Epileptic Seizure

The occurrence of tonic clonic convulsion in an irregularly monitored epileptic patient may pose a problem of differential diagnosis with other convulsant pathologies such as cerebral malaria. We are reporting a case of cerebral malaria that occurred in an epileptic patient whose seizures had been taken as a status epilepticus, the consequence of which was a delay diagnosis of malaria. The objective is to contribute to better monitoring of people with epilepsy. This is about a young 27-year-oldepileptic person who had stopped his treatment and was admitted to hospital on August 12th 2015 for subintrant tonic clonic seizures associated with loss of consciousness. The examination upon admission revealed a general poor condition with a clouded consciousness, colored anicteric conjunctiva, an infectious syndrome with a temperature at 39°C, severe dehydration, Heart Function at 137 beats/min, Blood Pressure at 140/90 mmHg, claret red urine (hemoglobinuria). Bicarbonates were reduced to 15 mmol/l (acidosis), the creatinine 154.6 mmol/l (functional renal failure) and thick smear came back positive with a parasite density at 819 parasites/ml. Under treatment with artemether, Depakine and amlodipine, the outcome was favorable and he was discharged/released from hospital on August 18th 2015. The occurrence of subintrant tonic-clonic seizures in an epileptic patient must lead to search and quickly eliminate an infectious cause of convulsions such as cerebral malaria.