A 42-year-old man is admitted to a UK ITU with cerebral malaria (GCS 8, P. falciparum parasitaemia 14%). He is commenced on IV artesunate. On day 2, h...

Question

A 42-year-old man is admitted to a UK ITU with cerebral malaria (GCS 8, P. falciparum parasitaemia 14%). He is commenced on IV artesunate. On day 2, he develops a generalised tonic-clonic seizure lasting 3 minutes. What is the most appropriate anticonvulsant management?

Accepted Answer

Treat the acute seizure with IV benzodiazepine; do NOT give prophylactic anticonvulsants routinely as trials showed increased mortality with prophylactic phenobarbitone

Answer

Prophylactic phenobarbitone for all patients with cerebral malaria

Answer

Oral carbamazepine prophylaxis

Answer

No treatment; seizures in cerebral malaria are self-limiting

Answer

IV mannitol to reduce intracranial pressure

uk-dtmh MCQ (SBA): Seizures in Cerebral Malaria

A 42-year-old man is admitted to a UK ITU with cerebral malaria (GCS 8, P. falciparum parasitaemia 14%). He is commenced on IV artesunate. On day 2, he develops a generalised tonic-clonic seizure lasting 3 minutes. What is the most appropriate anticonvulsant management?