True about cerebral malaria is childrena) Quinine is drug of choiceb) Hypoglycemiac) Good prognosisd) Caused by P. vivax

**Core Concept**
Cerebral malaria is a severe and life-threatening complication of Plasmodium falciparum infection, characterized by the presence of parasites in the brain tissue, leading to impaired consciousness, seizures, and even death if not promptly treated. The pathophysiology involves the sequestration of infected erythrocytes in the brain microvasculature, which triggers a localized inflammatory response and disrupts the blood-brain barrier.

**Why the Correct Answer is Right**
The correct answer is **b) Hypoglycemia**. Cerebral malaria is often associated with hypoglycemia due to the increased glucose utilization by the brain and the parasite. Additionally, the inflammatory response and cytokine release can lead to impaired glucose production and release. Hypoglycemia is a common feature in cerebral malaria and is a key indicator of disease severity. **Plasmodium falciparum** infection also triggers the release of various cytokines and inflammatory mediators, which contribute to the pathogenesis of cerebral malaria.

**Why Each Wrong Option is Incorrect**
**Option A:** Quinine is indeed an effective antimalarial drug, but it is not the first-line treatment for cerebral malaria. Artesunate, a derivative of artemisinin, is the preferred treatment due to its faster onset of action and higher efficacy.

**Option C:** Cerebral malaria has a poor prognosis if not promptly treated. The mortality rate can be as high as 20% if treatment is delayed.

**Option D:** Cerebral malaria is specifically caused by **Plasmodium falciparum**, not **P. vivax**. While **P. vivax** can cause malaria, it is not associated with cerebral malaria.

**Clinical Pearl / High-Yield Fact**
Cerebral malaria is a medical emergency that requires prompt recognition and treatment. The presence of impaired consciousness, seizures, or hypoglycemia should raise suspicion for cerebral malaria, and immediate antimalarial treatment with artesunate should be initiated.

**Correct Answer:** b. Hypoglycemia