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Background <p>Movement disorders associated with malaria are often underrecognized. This review aimed to systematically assess their types, onset patterns, and clinical outcomes.</p> Methods <p>We systematically searched major databases for case reports, case series, and cohort studies describing movement disorders in malaria patients. Data were extracted on demographics, <i>Plasmodium</i> species, clinical presentation, imaging, treatment, and outcomes. PRISMA guidelines were followed throughout.</p> Results <p>A total of 86 individual cases were identified from 72 case reports/series, along with 12 cohort studies were also reviewed. Among individual cases, <i>Plasmodium falciparum</i> was implicated in 75%, and P. vivax in 20%. Cerebellar ataxia was the most common movement disorder, reported in 52% of cases, often appearing 7–21&#xa0;days after fever resolution. Tremor (16%), dystonia (9%), and chorea (7%) were also documented. Extrapyramidal symptoms, including acute dystonia and rigidity, were observed in 43 children and adolescents treated with artesunate-amodiaquine, with a median onset of 2&#xa0;days post-treatment. Neuroimaging was normal in 68% of cases, while Cerebrospinal fluid findings were nonspecific. Most patients recovered completely within 1–4&#xa0;months; however, 4 cases required prolonged rehabilitation. Twelve cohort studies linked malaria, especially <i>Plasmodium falciparum</i>, to movement disorders like cerebellar ataxia. Most cases were immune-mediated with full recovery. Extrapyramidal effects and posturing also occurred, highlighting the importance of drug monitoring.</p> Conclusions <p>Movement disorders in malaria are rare but clinically significant. They may occur during acute illness or weeks later, often linked to <i>Plasmodium&#xa0;falciparum</i> or antimalarial drugs. Early identification and supportive care usually lead to favorable outcomes.</p>

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Spectrum of movement disorders in Malaria: a systematic review of case reports, case series, and cohort studies

  • 期刊论文

  • 发表日期：

    2025年6月19日

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  • Ravindra Kumar Garg,
  • Shweta Pandey,
  • Raza Abbas Mahdi,
  • Apoorva Agrawal,
  • Ravi Uniyal,
  • Sanjay Singhal

摘要

Background

Movement disorders associated with malaria are often underrecognized. This review aimed to systematically assess their types, onset patterns, and clinical outcomes.

Methods

We systematically searched major databases for case reports, case series, and cohort studies describing movement disorders in malaria patients. Data were extracted on demographics, Plasmodium species, clinical presentation, imaging, treatment, and outcomes. PRISMA guidelines were followed throughout.

Results

A total of 86 individual cases were identified from 72 case reports/series, along with 12 cohort studies were also reviewed. Among individual cases, Plasmodium falciparum was implicated in 75%, and P. vivax in 20%. Cerebellar ataxia was the most common movement disorder, reported in 52% of cases, often appearing 7–21 days after fever resolution. Tremor (16%), dystonia (9%), and chorea (7%) were also documented. Extrapyramidal symptoms, including acute dystonia and rigidity, were observed in 43 children and adolescents treated with artesunate-amodiaquine, with a median onset of 2 days post-treatment. Neuroimaging was normal in 68% of cases, while Cerebrospinal fluid findings were nonspecific. Most patients recovered completely within 1–4 months; however, 4 cases required prolonged rehabilitation. Twelve cohort studies linked malaria, especially Plasmodium falciparum, to movement disorders like cerebellar ataxia. Most cases were immune-mediated with full recovery. Extrapyramidal effects and posturing also occurred, highlighting the importance of drug monitoring.

Conclusions

Movement disorders in malaria are rare but clinically significant. They may occur during acute illness or weeks later, often linked to Plasmodium falciparum or antimalarial drugs. Early identification and supportive care usually lead to favorable outcomes.