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Rapid response to:

Clinical Review

Febrile seizures

BMJ 2007; 334 doi: https://doi.org/10.1136/bmj.39087.691817.AE (Published 08 February 2007) Cite this as: BMJ 2007;334:307

Rapid Response:

Cerebral Malaria should not be overlooked as a differential diagnosis to febrile convulsions in Tropics.

Editor- Sir, it is surprising to note in this, very informative
clinical review by Lynette GS and Ingrid ES that they did not mention
Cerebral Malaria as a differential diagnosis to febrile convulsions1. In
places where malaria transmission is intense, malaria can be both a cause
of febrile seizures as well as may present as convulsions with fever in
cerebral malaria caused by Plasmodium falciparum2,3,4. So appropriate
tests and treatment should be considered in countries (mainly tropical)
where malaria is endemic. A thin and thick blood film and hematocrit are
easy investigations and can be done in resource constraint settings too.

References:

1) Sadler LG, Scheffer IE. Febrile seizures. BMJ 2007;334:307-311.

2) Akpede GO, Sykes RM, Abiodun PO. Convulsions with malaria: febrile
or indicative of cerebral involvement?J Trop Pediatr.1993;39(6):350-5.

3) Osuntokun BO Malaria and the nervous system. Afr J Med Med
Sci.1983;12(3-4):165-72.

4) Phillips RE, Solomon T Cerebral malaria in children. Lancet. 1990
Dec 1;336(8727):1355-60

Competing interests:
None declared

Competing interests: No competing interests

16 April 2007
Neeru Gupta
Assistant Director General
Indian Council of Medical Research, Ansari Nagar, New Delhi-110029