Skip to main content

Advertisement

Table 1 Characteristics of patients with posturing

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

Clinical and laboratory characteristics, and changes during admission Patients with no posturing (n = 254) Patients posturing at admission (n = 85) P value Patients posturing after admission (n = 78) P value
Clinical characteristics on admission
Sex, male (%) 130 (51.2) 43 (50.6) 0.93 42 (53.8) 0.68
Mean (SD) age in months 28.4(20.1) 38.0(25.7) 0.01 35.0 (21.0) 0.01
Median (IQR) duration of illness in days 2.0 (1 – 3) 2.0 (1 – 3) - 2.0 (0.3 – 3) -
History of seizures, (%) 217 (85.4) 72 (85.7) 0.95 66 (84.6) 0.86
Median (IQR) duration of coma before admission in hrs 3 (2 – 6) 3 (2 – 6) - 4 (2 – 6) -
Mean (SD) axillary temperature °C 38.0 (4.3) 38.7 (7.0) 0.25 38.8 (7.2) 0.22
Deep (acidotic) breathing, (%) 69 (27.2) 26 (30.6) 0.54 24 (30.8) 0.54
Profound coma (BCS 0, (%)) 58 (22.8) 15 (17.6) 0.31 19 (24.4) 0.78
Retinal haemorrhages, (%) 18 (7.1) 15 (17.6) 0.01 11 (14.1) 0.07
Laboratory investigations on admission
Severe anaemia, (haemoglobin < 5.0 g/dl, (%)) 54 (22.3) 17 (20.5) 0.73 14 (18.4) 0.47
Hypoglycaemia, (Glucose < 2.2 mmol/L, (%)) 51 (21.3) 14 (17.7) 0.50 17 (23.3) 0.71
Severe acidosis, (Base excess < – 15, (%)) 56 (24.6) 19 (25.3) 0.89 23 (32.9) 0.17
Hyponatraemia, (Plasma sodium < 135 mmol/L, (%)) 114 (47.7) 39 (51.3) 0.58 32 (43.8) 0.56
Mean log10 (SD) of parasite density 4.8 (1.2) 4.8 (1.2) 0.77 4.7 (1.3) 0.39
Hyperparasitaemia, (> 20% parasitaemia, (%)) 77 (31.8) 22 (26.5) 0.36 24 (31.6) 0.97
Brainstem features of raised ICP observed during admission
Deterioration in level of consciousness, (%) 64 (25.2) 39 (45.9) <0.01 43 (55.1) <0.001
Sluggish pupillary reaction, (%) 82 (32.4) 37 (43.5) 0.06 30 (38.5) 0.32
Non-reactive pupils, (%) 12 (4.7) 3 (3.5) 0.77* 4 (5.1) 1.00*
Pupillary sizes, (%)      
   Constricted 42 (16.5) 6 (7.1) 0.03 8 (10.3) 0.18
   Dilated 41 (16.2) 24 (28.6) 0.01 19 (24.4) 0.10
   Unequal 3 (1.2) 3 (3.5) 0.17* 3 (3.8) 0.14*
Dysconjugate gaze, (%) 42 (17.1) 28 (33.3) <0.01 20 (26.0) 0.08
Congested retinal veins, blurred disc margins or overt papilloedema, (%) 16 (6.3) 14 (16.5) <0.01 18 (23.1) <0.001
Horizontal oculocephalic eye deviation, (%)      
   No deviation 17 (6.7) 5 (5.9) 0.79 6 (7.7) 0.76
   Minimal deviation 44 (17.3) 16 (18.8) 0.75 11 (14.1) 0.50
Abnormalities in respiration, (%)      
   Irregular 49 (19.3) 18 (21.2) 0.71 20 (25.6) 0.23
   Shallow 42 (16.5) 6 (7.1) 0.03 14 (17.9) 0.77
   Respiratory arrest 12 (4.7) 9 (10.6) 0.05 10 (12.8) 0.01
Seizures
Clinical seizures witnessed in the ward, (%) 29 (50.8) 49 (57.6) 0.27 58 (74.4) <0.001
Type of witnessed seizures, (%)      
   Partial 74 (29.1) 28 (32.9) 0.51 38 (48.7) <0.01
   Partial with secondary generalisation 29 (11.4) 11 (12.9) 0.71 16 (20.5) 0.04
   Generalised 81 (31.9) 28 (32.9) 0.86 39 (50.0) <0.01
Outcome
Mortality, (%) 32 (12.6) 15 (17.6) 0.24 16 (20.5) 0.08
Neurological deficits, (%) 17 (6.7) 7 (8.2) 0.63 15 (19.5) <0.01
  1. * Fisher's exact test (two tailed)