Seizures are a frequent manifestation of severe malaria in children especially those less than 5 years of age. Although
simple febrile seizures occur in young children of the same age group, for a long time it has not been established
whether seizures following severe malaria in children of this age group are a consequence of febrile illness or due to cerebral
The possibility of determining whether these seizures are simply febrile or due to cerebral involvement is important for
accuracy of diagnosis and case management; it forms the basis for making prognostic assessments and predicting future
neurologic outcome as part of the burden of the disease in sub-Saharan Africa. The purpose of this review is not to produce
any new findings. Instead, we aim to present existing evidence for and against the possible involvement of the central
nervous system in seizures accompanying cerebral malaria. This review reveals that controversy still exists and the
weight of evidence seems to be on the side of a direct neurologic involvement in patients with seizures from cerebral malaria.
We conclude with a call for a heightened sense of awareness and the establishment of stringent treatment regimens
in patients who present with malaria complicated by seizures.