A ten-year retrospective review of antimalarial-induced dystonia at Wesley Guild Hospital, Ilesa.

Authors

O A Oyedeji, Sba Oseni, T Ogundele, O Oroge, V T Olaitan, B G Ologun

Published in

Journal of vector borne diseases. Jul 29, 2026. Epub Jul 29, 2026.

Abstract

Antimalarial induced dystonia (AID) is a paediatric emergency. It is a rare adverse reaction to antimalarial therapy. Available, information on AID is almost entirely from case reports, thus necessitating this report. To study managed cases of AID at a Paediatric Emergency unit (PEU), with the view of identify causative factors and recommending evidence-based preventive strategies.
Information was extracted from case notes of children with AID over a 10year period at the PEU of Wesley Guild Hospital, (WGH). Data obtained was analyzed.
The 23 AID admissions (12 boys and 11girls) aged between 4 and 13 years constituted 0.8% of the total 2830 PEU malaria admissions. Admission duration ranged 1 - 3 days for AID. No case of malaria managed at WGH developed dystonia. The malaria medications (MM) associated with AID were Artesunate /Amodiaquine (AA) combination, Amodiaquine(AM), Chloroquine (CH), Artesunate/Piperiquine Phosphate, and Artesunate/Lumefantrine combination in 12, 7, 2,1 and 1 cases respectively. Malaria management before development of AID was presumptive. These MM were mostly prescribed by chemists and parents. Over-dosages of AA, AM and CH were recorded in 10, 2 and 1 case respectively. Compared with other antimalarials, significantly more, aged based fixed dose combinations of AA were associated with dystonia (P<0.05). Generalized dystonia had significantly longer admission duration than focal (P<0.05).
The AA combination is the most common antimalarial associated with AID. Presumptive malaria treatment and non-pharmaceutical dispensations should be discouraged. Recommended doses of AA should be weight based in order to prevent over-dosage and AID.

PMID:
42574148
Bibliographic data and abstract were imported from PubMed on 11 Aug 2026.

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