Cerebral malaria, meningitis and encephalitis are the most common causes of acute encephalopathies in children in sub-Saharan Africa. All are associated with seizures and may be complicated by shock and intracranial hypertension. These features are associated with prolonged coma, increased mortality and both short and long-term cognitive and neurological deficits. Children with multiple risk factors have even poorer outcomes.
Seizures may be completely unapparent clinically. Clinical signs of intracranial hypertension are a late feature and intracranial pressure monitoring is an invasive procedure unavailable in most health units in sub-Saharan Africa.