Neuropathological assessment of artemether-treated severe malaria

In animals, high doses of intramuscular artemether and artemotil have been shown to cause an unusual pattern of selective damage to certain brainstem nuclei, especially those implicated in hearing and balance. We aimed to investigate whether a similar pattern arises in human adults. We examined the brainstems of adults who died after treatment with high dose artemether or quinine for severe falciparum malaria for evidence of a pattern of selective neuronal damage. Neuropathological findings were similar in recipients of quinine (n = 15) and artemether (n = 6; total artemether doses received 4-44 mg/kg). No evidence was recorded for artemether-induced neurotoxic effects.