Management of the extrapyramidal syndrome in chronic acquired hepatocerebral degeneration (CAHD)

✍ Scribed by Spiridon Papapetropoulos; Carlos Singer

• Book ID: 102506891
• Publisher: John Wiley and Sons
• Year: 2005
• Tongue: English
• Weight: 43 KB
• Volume: 20
• Category: Article
• ISSN: 0885-3185
• DOI: 10.1002/mds.20585

✦ Synopsis

We believe that a mutant strain of plasmodium falcipaurm that has novel surface antigen is responsible in our patient, as no such complication has been recorded in the past. It is also known that the malaria parasite can readily show fast antigenic variation that leads to alteration in host immunity. 9 Alternatively, an untreated DCA patient may later lapse into cerebral malaria due to an altered host-parasite immunological response. Immune activation in DCA following plasmodium falciparum malaria was proposed by de Silva and colleagues 10 ; this was later refuted by their further observations. 11 We conclude that in the endemic area acute cerebellar ataxia following febrile illness, falciparum malaria warrants first consideration. Both peripheral blood smear microscopy and antigenic test may be negative and PCR is the gold-standard test for early diagnosis. DCA may be followed by cerebral malaria, and early diagnosis during DCA period may prevent cerebral malaria.