Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Unusual meuromuscular complications falciparum malaria(CAB International, 1994) de Silva, H.J.; de Silva, N.R.The involvement of the nervous system in Plasmodium falciparum malaria is a complex problem, and several mechanisms including mechanical obstruction of the microcirculation and immune mediated damage probably play a role in the pathogenesis. This review focuses attention on some of the more unusual neurological complications of falciparum malaria. Several neuropsychiatric manifestations have been reported during attacks of malaria and following use of antimalarial drugs.Item Absence of anti-Purkinje cell antibodies in patients with cerebellar ataxia following falciparum malaria(SEAMEO Regional Tropical Medicine and Public Health Project, 1994) de Silva, H.J.; Senanayake, N.Immunological mechanisms have been implicated in the pathogenesis of delayed cerebellar ataxia following falciparum malaria (DCA). We tested serum and CSF samples obtained from 39 Sri Lankan patients with DCA for the presence of antibodies (Ab) directed against cerebellar Purkinje cells by an immunofluorescence (IF) technique and Western blot analysis. For the IF test 7 mu thick frozen sections of histologically normal cerebellum obtained at post mortem were used. Proteins obtained from crude preparations of Purkinje cells isolated from the cerebellum were used for Western blot analysis. Sera obtained from patients known to have antineuronal antibodies associated with cerebellar degenerations and paraneoplastic disorders (anti-Hu and anti-Yo Ab) and sera from normal blood donors served as positive and negative controls, respectively. All serum and CSF samples obtained from patients with DCA were negative for Ab directed against cerebellar Purkinje cells. Humoral mechanisms are, therefore, unlikely to be important in the pathogenesis of this delayed complication of falciparum malaria.Item Immune activation during cerebellar dysfunction following Plasmodium falciparum malaria(Oxford University Press, 1992) de Silva, H.J.; Hoang, P.; Dalton, H.; de Silva, N.R.; Jewell, D.P.; Peiris, J.B.Evidence for immune activation was investigated in 12 patients with a rare syndrome of self-limiting, delayed onset cerebellar dysfunction following an attack of falciparum malaria which occurred 18-26 d previously. Concentrations of tumour necrosis factor, interleukin 6 and interleukin 2 were all significantly higher in serum samples of patients during cerebellar ataxia than in recovery sera and in the sera of 8 patients who did not develop delayed cerebellar dysfunction following an attack of falciparum malaria. Cytokine concentrations in the cerebrospinal fluid were also significantly higher in ataxic patients than in controls. These findings suggest that immunological mechanisms may play a role in delayed cerebellar dysfunction following falciparum malaria.