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Table 2 Biological and radiological features of PMNS post P. falciparum, P. vivax or mixed infection

From: Post-malaria neurological syndrome: four cases, review of the literature and clarification of the nosological framework

  CSF (WBC/%L) CSF protein (g/L) CRP (mg/L) EEG MRI MRI matching ADEM or AIE
P. falciparum infection
 Case 1 32/90 1.05 N Abnormal N
 Case 2 82/87 2.41 N Abnormal Limbic and hippocampal hypersignal ADEM plausible
 Case 3 173/89 1.88 40 Abnormal N
 Case 4 NA NA N NA NA  
 Nguyen [4] (N = 22) > 5 in 8/lymphocytic predominance > 0.5 in 13 NA NA NA  
O’Brien [6] NA NA NA NA WM lesions in CH, brainstem, cerebellum, thalamus and basal ganglia ADEM plausible
Zambito [7] 20/100 0.86 NA Abnormal N
Mizuno [8] 10/100 0.83 27 Abnormal N
Nayak [9] N/N 0.66 NA NA NA  
Prendki [10] 76/100 0.52 163 Abnormal N
Prendki [10] 26/91 1.88 9 Abnormal N
Falchook [11] NA NA N NA Pons, posterior internal capsule, thalamus, corona radiata, and periventricular hypersignal ADEM unlikely
Matias [12] N/N 1.83 N Abnormal Extensive demyelinating lesions (subcortical WM and cerebellum) ADEM or dysimmune plausible
Markley [13] 20/100 0.92 NA Abnormal N
Forestier [14] 43/95 1.2 N Abnormal N
Rakoto.[15] 31/98 2 N NA NA  
Pace [16] NA NA 8 NA Brainstem and spinal cord high signal and swelling ADEM plausible
Caetano [17] 123/100 1.88 NA Normal N  
Mohsen [18] 22/100 1.4 NA Abnormal Subcortical unilateral frontal and temporal, and cerebellar hypersignal with gadolinium enhancement ADEM unlikely but not impossible
Schnorf [19] 10/95 0.6 NA Abnormal Peri and supraventricular and cerebellar hypersignal ADEM plausible
Schnorf [19] 80/87 1.8 NA Abnormal N  
Agrawal [20] 5/100 1.12 NA NA Asymmetric supraventricular, semi-ovale center, genu of corpus callosum WM hypersignal NA
Rachita [21] 7/100 1.25 NA NA Multifocal asymmetric diffuse WM hypersignal with small mass effect ADEM
Lawn [22] N/N 0.89 N NA N
Lawn [22] 59/100 2.89 N Abnormal N
Total abnormal 25/42 33/42 5/14 14/15 9/21  
% abnormal [95% CI] 59.5 [44.5–72.9] 78.6 [64.1–88.3] 35.7 [16.3–61.3] 93.3 [70.2–98.8] 42.8 [24.5–63.5]  
Mean WBC/%L (SD) 48a/96a (46)/(5.1) 1.4b (0.6) 49.4c (64.9)    
Median WBC/%L (min–max) 31a/100a (5–173)/(87–100) 1.2b (0.5–2.9) 27c (8–163)    
P. vivax infection
 Goyal [23] 70/NA 0.5 NA NA Diffuse periventricular, deep and subcortical WM hypersignal  
 Sidhu [24] NA NA NA NA Subcortical, cortical, left parietal periventricular regions and pons hypersignal  
 Kochar [25] NA NA NA NA NA  
 Kasundra [26] 10/100 0.65 NA NA T1-weighted isointense and T2 and fluid-attenuated inversion recovery high signal in bilateral cerebellar hemispheres including vermis  
Mixed infection
 Koibuchi [27] 30/NA 0.46 52 NA Asymmetric spotty mottled cortical and subcortical lesions  
 Mani [28] NA   NA NA Multifocal confluent areas of demyelination in the corpus callosum and periventricular region, myelitis  
  1. Meningitis is defined in the CSF by CSF WBC ≥ 5/mL. CSF Protein ≥ 0.5 g/L is considered abnormal. CRP normal value ≤ 5 mg/L
  2. CSF cerebrospinal fluid, WBC white blood count, %L proportion of lymphocytes, CRP c-reactive protein, WM white matter, NA not available, N normal, ADEM acute disseminated encephalomyelitis, AIE autoimmune encephalitis, LP lumbar puncture, SD standard deviation, [95% CI] 95% confidence interval
  3. aCalculated on abnormal and available figured data, n = 17
  4. bCalculated on abnormal and available figured data, n = 20
  5. cCalculated on abnormal and available figured data, n = 5