| CASE REPORT |
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| Year : 2015 | Volume
: 10
| Issue : 1 | Page : 58-60 |
Post-Plasmodium vivax malaria cerebellar ataxia and optic neuritis: A new form of delayed cerebellar ataxia or cerebellar variant of acute disseminated encephalomyelitis?
Gaurav M Kasundra1, Amita Narendra Bhargava1, Bharat Bhushan1, Khichar Shubhakaran1, Isha Sood2
1 Department of Neurology, Dr. S. N. Medical College and M. G. Hospital, Jodhpur, Rajasthan, India
2 Department of Medicine, Dr. S. N. Medical College and M. G. Hospital, Jodhpur, Rajasthan, India
Correspondence Address:
Isha Sood
122, Subhash Nagar, Pal Road, Jodhpur 342 008, Rajasthan
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1817-1745.154354
Acute disseminated encephalomyelitis (ADEM) is commonly seen after viral and bacterial infections, immunization, and Plasmodium falciparum (PF) malaria. Plasmodium vivax (PV) rarely causes ADEM. We report a 14-year-old female patient who presented with acute onset bilateral cerebellar ataxia and optic neuritis, 2 weeks after recovery from PV. Magnetic resonance imaging showed bilateral cerebellar hyperintensities suggestive of ADEM. No specific viral etiology was found on cerebrospinal fluid examination. Patient responded well to treatment without any sequelae. Thus, PV too is an important cause of ADEM along with PF. Two of the previously reported cases had co-infection with falciparum malaria. The only other two reported cases, as also this patient, are from Asia. A geographical or racial predisposition needs to be evaluated. Also, a possibility of post-PV delayed cerebellar ataxia, which is classically described post-PF infection, may be considered as it may be clinically, radiologically, and prognostically indistinguishable from a milder presentation of ADEM.
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