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Routine anticonvulsants for treating cerebral malaria

  • Review
  • Intervention


  • Martin M Meremikwu,

    Corresponding author
    1. University of Calabar Teaching Hospital, Department of Paediatrics, Calabar, Cross River State, Nigeria
    • Martin M Meremikwu, Department of Paediatrics, University of Calabar Teaching Hospital, PMB 1115, Calabar, Cross River State, Nigeria.

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  • Anthony G Marson

    1. Clinical Sciences Centre for Research & Education, University Department of Neurological Science, Liverpool, Merseyside, UK
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Cerebral malaria is a common complication of Plasmodium falciparum infection, and kills over a million people every year. People with cerebral malaria become unconscious, and often have protracted convulsions. It is unclear whether giving anticonvulsant drugs routinely to people with cerebral malaria will improve the outcome of treatment and prevent death.


To evaluate the effect of routine anticonvulsant drugs in people with cerebral malaria.

Search methods

We searched the Cochrane Infectious Diseases Group Specialized Register (May 2004), CENTRAL (The Cochrane Library Issue 2, 2004), MEDLINE (1966 to May 2004), EMBASE (1988 to May 2004), LILACS (1982 to May 200), Science Citation Index (May 2004), African Index Medicus (1999), reference lists of articles, and research organizations. We also contacted the authors for additional information.

Selection criteria

Randomized and quasi-randomized controlled trials of people with cerebral malaria. The trials compared anticonvulsant drugs started on admission to hospital with no anticonvulsant drug or placebo.

Data collection and analysis

Two reviewers independently extracted data from those trials eligible for inclusion. We assessed the risk of bias in the included trials by considering allocation sequence, concealment of allocation, blinding, and inclusion of all randomized participants. We used Review Manager (version 4.1) for the meta-analysis and also explored possible sources of heterogeneity.

Main results

Three trials with a total of 573 participants met the inclusion criteria. These trials all compared phenobarbitone with placebo or no treatment. In the two trials with adequate allocation concealment, death was more common in the anticonvulsant group (Risk Ratio 2.0; 95% confidence interval 1.20 to 3.33; fixed effect model). In all three trials, phenobarbitone compared with placebo or no treatment was associated with fewer convulsions (Risk Ratio 0.30; 95% confidence interval 0.19 to 0.45; fixed effect model).

Authors' conclusions

Routine phenobarbitone in cerebral malaria is associated with fewer convulsions but possibly more deaths. Further trials with adequate design, more participants, and different doses of anticonvulsant drugs are needed.




腦性瘧疾是1種因為惡性瘧原蟲(Plasmodium falciparum)感染所引起的常見併發症,而且它每年會奪去超過100萬人的性命。患有腦性瘧疾的人們會變成沒有意識,而且常常會發生持久性的抽搐。目前並不清楚是否例行性給予抗痙攣藥物改善治療腦性瘧疾的結果以及預防死亡。




我們搜尋Cochrane Infectious Diseases Group Specialized Register (2004年5月)、CENTRAL (Cochrane Library Issue 2, 2004)、 MEDLINE (1966年to 2004年5月)、EMBASE (1988年−2004年5月)、 LILACS (1982年 – 2004年5月)、 Science Citation Index (2004年5月)、 African Index Medicus (1999)、 文章的參考文獻以及研究機構。並與作者聯繫已取得額外資訊。.




有2位審稿者從這些符合收集規定的試驗當中,獨立地擷取出了資料。針對這些被收集在內的試驗而言,我們藉由考量分配順序、隱藏分配工作、盲法,以及對所有隨機化之參與者的收集工作等方面,來評估了這些試驗在方法層面上的品質。我們使用了Review Manager(第4.1版)作統合分析,同時還探討了質異性方面的可能來源。






此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。



Plain language summary

Routine anticonvulsants for treating cerebral malaria

Plain language summary pending.

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