Clinical and neurophysiological study of the effects of multiple doses of artemisinin on brain-stem function in Vietnamese patients.

E KissingerWellcome Trust Clinical Research Unit, Centre for Tropical Diseases, Ho Chi Minh City, Vietnam.

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T T HienWellcome Trust Clinical Research Unit, Centre for Tropical Diseases, Ho Chi Minh City, Vietnam.

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N T HungWellcome Trust Clinical Research Unit, Centre for Tropical Diseases, Ho Chi Minh City, Vietnam.

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N D NamWellcome Trust Clinical Research Unit, Centre for Tropical Diseases, Ho Chi Minh City, Vietnam.

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N L TuyenWellcome Trust Clinical Research Unit, Centre for Tropical Diseases, Ho Chi Minh City, Vietnam.

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B V DinhWellcome Trust Clinical Research Unit, Centre for Tropical Diseases, Ho Chi Minh City, Vietnam.

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C MannWellcome Trust Clinical Research Unit, Centre for Tropical Diseases, Ho Chi Minh City, Vietnam.

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N H PhuWellcome Trust Clinical Research Unit, Centre for Tropical Diseases, Ho Chi Minh City, Vietnam.

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P P LocWellcome Trust Clinical Research Unit, Centre for Tropical Diseases, Ho Chi Minh City, Vietnam.

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J A SimpsonWellcome Trust Clinical Research Unit, Centre for Tropical Diseases, Ho Chi Minh City, Vietnam.

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N J WhiteWellcome Trust Clinical Research Unit, Centre for Tropical Diseases, Ho Chi Minh City, Vietnam.

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J J FarrarWellcome Trust Clinical Research Unit, Centre for Tropical Diseases, Ho Chi Minh City, Vietnam.

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The qinghaosu (artemisinin) group of drugs is the most important new class of antimalarials developed in the last fifty years. Although there has been no clinical evidence of neurotoxicity, an unusual pattern of damage to specific brain-stem nuclei has been reported in experimental animals receiving high doses of arteether or artemether. Detailed clinical examinations, audiometry, and brain stem auditory evoked potentials (BSAEPs) were assessed in 242 Vietnamese subjects who had previously received up to 21 antimalarial treatment courses of artemisinin or artesunate alone and 108 controls from the same location who had not received these drugs. There was no evidence of a drug effect on the clinical or neurophysiological parameters assessed. In this population there was no clinical or neurophysiological evidence of brain-stem toxicity that could be attributed to exposure to artemisinin or artesunate.

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