Case Reports J Vect Borne Dis 44, September 2007, pp. 227–229 Post-malaria neurological syndrome – a case of bilateral facial palsy after Plasmodium vivax malaria D.K. Kochar, Parmendra Sirohi, S.K. Kochar, Dinesh Bindal, Abhishek Kochar, Ashok Jhajharia & Jitendra Goswami Department of Medicine, S.P. Medical College, Bikaner, Rajasthan, India Key words Bilateral facial palsy – Plasmodium vivax – post-malaria neurological syndrome Background: Post-malaria neurological syndrome (PMNS) is defined as the acute onset of neurological or neuropsychiatric syndrome in a patient who had recently recovered from malaria and have negative blood film at the time of onset of neurological symptoms. This, therefore, distinguishes it from cerebral malaria, which occurs during the period of parasitaemia. The time from eradication of systemic parasitaemia to the development of this syndrome can be up to nine weeks 1 . The prevalence of PMNS in patients with malaria is 0.12% and is 300 times more common in patients with severe malaria in comparison to uncomplicated malaria 1 . The reported clinical features include generalised convulsions, acute confusional state, psychosis, tremors, cerebellar ataxia, motor aphasia, and generalised myoclonus 2,3 . Most of these patients made complete recovery without specific treatment. Almost all reported PMNS cases are associated with episode of P. falciparum malaria. We report a case of bilateral facial palsy developing on 14th day of afebrile period after successful treatment of vivax malaria and had complete recovery in next four weeks. Case report: A 55 year-old male (RG) was admitted in the hospital with complaints of fever, nausea and vomiting for last four days. Fever was associated with chills and rigors, and occurring on alternate days. Patient was conscious, oriented and there was no icterus, pallor, lymphadenopathy or cynosis. Skin was of normal texture and other systems including cardiovascular, respiratory, nervous system were normal. Peripheral blood film (PBF) for malarial parasite was positive for P. vivax (Fig. 1), which was Fig. 1: Peripheral blood examination showing evidence of P. vivax infection