@article{fdi:010013698,
  title = {{T}hree probable cases of {L}oa loa encephalopathy following ivermectin treatment for onchocerciasis},
  author = {{B}oussinesq, {M}ichel and {G}ardon, {J}acques and {G}ardon-{W}endel, {N}. and {K}amgno, {J}. and {N}goumou, {P}. and {C}hippaux, {J}ean-{P}hilippe},
  editor = {},
  language = {{ENG}},
  abstract = {{O}ver the past nine years, more than 12 million people exposed to #{O}nchocerca volvulus$ infection have received at least one dose of ivermectin, almost all without serious adverse reactions. {S}ince 1991, however, several cases with neurologic manifestations, including coma, have been reported after ivermectin treatment of persons infected with #{O}. volvulus$ who also had concomitant #{L}oa loa$ infection with very high microfilaremia (>50,000 microfilariae/ml of blood). {I}n 1995, four criteria were established to define probable cases of {L}oa encephalopathy temporally related to treatment with ivermectin ({PLERI}). {T}he present paper describes three {PLERI} cases recorded in {C}ameroon and compares them with two others reported previously. {D}isorders of consciousness began 3-4 days after treatment. {T}he objective neurologic signs were variable. {T}he conditions improved favorably in three patients who benefited from early hospitalization and good nursing ; their disorders of consciousness lasted only 2-3 days ; the results of clinical examination became normal after one month and electroencephalographic abnormalities disappeared after 5-7 months. {C}onversely, late diagnosis and delay in proper management in two others probably led to worsening of the condition and to fatal outcome related to the usual complications of coma. {I}n addition to these cases, patients with high #{L}oa$ microfilaremia also developped milder neurologic manifestations causing functional impairment lasting for at least one week after treatment. {B}efore launching mass ivermectin distribution programs to control onchocerciasis in central {A}frica, communities in which the intensity of concomittant #{L}. loa$ microfilaremia is high need to be identified, and specific educational measures and monitoring strategies should be developed and applied before they are treated. ({R}{\'e}sum{\'e} d'auteur)},
  keywords = {{ONCHOCERCOSE} ; {LOASE} ; {ETUDE} {DE} {CAS} ; {FACIES} {EPIDEMIOLOGIQUE} ; {CHIMIOTHERAPIE} {DE} {MASSE} ; {ENCEPHALOPATHIE} ; {IVERMECTINE} ; {MECTIZAN} ; {DIETHYLCARBAMAZINE} ; {DEC} ; {EFFET} {SECONDAIRE} ; {CAMEROUN}},
  booktitle = {},
  journal = {{A}merican {J}ournal of {T}ropical {M}edicine and {H}ygiene},
  volume = {58},
  numero = {4},
  pages = {461--469},
  ISSN = {0002-9637},
  year = {1998},
  URL = {https://www.documentation.ird.fr/hor/fdi:010013698},
}