<div>Management</div><div>-Intravenous Phenytoin loading and maintenance, Oral Carbamazepine 400mg
twice/day and tonics</div><div>Hospital course:</div><div>The patient showed remarkable improvement in his cognitive function and
started to communicate with his family.</div><div>He had been referred back to his country as the combination therapy
Nifurtimox-Eflornithine for African Trypanosomiasis treatment is not
available in Sudan after separation.</div><div>Discussion</div><div>In our case we suspected late second stage African Trypanosomiasis with
neurological complications such as non convulsive state as the patient
presented with progressive decline of his cognitive function and our
suspicious was confirmed by EEG, and supported more by remarkable
cognitive improvement with Anti Convulsant thearpy.</div><div>Conclusion</div><div>Our case highlights that late second stage African Trypanosomiasis with
neurological complications such as non convulsive status epilepticus
should be suspected in any patient who developed progressive cognitive
decline and behavioral changes following long standing history of
African Trypanosomiasis and routine Electro-encephalogram EEG is the
best tool to diagnose non convulsive status epilepticus.</div><div>Medical health professionals should suspect second stage African
Trypanosomiasis with neurological complications such as non convulsive
status epilepticus in any patient who have history of African
Trypanosomiasis and developed progressive cognitive decline.</div><div>Early referral of the patients with second stage African Trypanosomiasis
with progressive cognitive decline to Neurology Centers with
Elector-encephalogram EEG facility might help to diagnose non convulsive
status epilepticus in conjunction with early clinical suspicion of the
condition will enhance the improvement of the prognosis.Further
reporting of such cases is recommended.</div>