Atypical neurological manifestations of dengue fever: a case series and mini review

Prabhat, Nandita; Ray, Sucharita; Chakravarty, Kamalesh; Kathuria, Heena; Sukriya, Saravana; Singh, Deependra; Rebello, Alex; Lakhanpal, Vikas; Goyal, Manoj; Lal, Vivek

doi:10.1136/postgradmedj-2020-137533

Cited by 16 publications

(24 citation statements)

References 16 publications

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“…Las complicaciones neurológicas de la infección por el virus del dengue se clasifican en tres categorías basadas en la patogenia, los trastornos producidos por una alteración metabólica, por la invasión viral, que incluye encefalitis, meningitis, miositis y mielitis; por reacciones autoinmunes, que incluyen encefalomielitis diseminada aguda, neuromielitis óptica, neuritis óptica, mielitis, encefalopatía y síndrome de Guillain-Barre (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16) .…”

Section: Discussionunclassified

“…Se ha relacionado al dengue como causa del SGB recientemente y cada vez se describen más casos (8)(9)(10)(11) . La patogenia del SGB, aún no se conoce por completo, se cree que las manifestaciones clínicas en el dengue se producen como consecuencia de una respuesta inmune alterada a antígenos no propios que pueden reaccionar de forma cruzada con la mielina o los axones de los nervios periféricos a través del mimetismo molecular, la respuesta de las células T activadas y la producción de citoquinas proinflamatorias, con componentes del complemento, favorecen, que los anticuerpos actúen sobre el compartimento endoneural y las células de Schwann, dando lugar al desarrollo del SGB (12)(13)(14)(15) . El tratamiento con plasmaféresis e inmunoglobulina intravenosa son eficaces (16) .…”

Section: Discussionunclassified

“…El Síndrome de SGB, puede ser secundario a diversas infecciones (Campylobacter jejuni, HIV, herpes virus, varicela zoster, citomegalovirus) y actualmente las arbovirosis, (virus ZIKA, chikungunya, y el virus del dengue), podrían ser potenciales agentes etiológicos, principalmente en regiones endémicas, la infección por el virus del Zika, es el que más produce SGB (8)(9)(10)(11)(12)(13)(14)(15)(16) .…”

Section: Discussionunclassified

See 2 more Smart Citations

Autoimmune manifestations in patients with dengue. Casuistry in the Internal Medicine Department of the Hospital Nacional, Paraguay

Jarolín

Taboada

Montiel

et al. 2020

Rev. Nac. (Itauguá)

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Section: Discussionunclassified

See 1 more Smart Citation

Autoimmune manifestations in patients with dengue. Casuistry in the Internal Medicine Department of the Hospital Nacional, Paraguay

Jarolín

Taboada

Montiel

et al. 2020

Rev. Nac. (Itauguá)

View full text Add to dashboard Cite

“…Dengue virus leads to a multisystemic disease but rarely infects the brain. Neurological complications are reported in 0.5–20% of cases 6,66 . They include encephalopathy due to multiorgan failure, brain hemorrhage due to coagulopathy, and postinfection neurological syndromes 5,6,58,66 …”

Section: Arthropod‐borne Rna Virusesmentioning

confidence: 99%

“…Movement disorders are rare but postinfection (immune mediated) disorders, such as opsoclonus‐myoclonus‐ataxia syndrome, parkinsonism, dystonia and tremor have been reported (Video 3). 6–10 Recently a rapidly progressive dementia with PSP‐like phenocopy was reported in a patient with chronic dengue encephalitis 67 …”

Section: Arthropod‐borne Rna Virusesmentioning

confidence: 99%

Video Anthology of Movement Disorders Due to Infections in South Asia

Aggarwal

Adukia

Bhatt

2021

Movement Disord Clin Pract

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South Asia, encompassing many populous countries including India, Pakistan, and Bangladesh, is home to a wide variety of infectious diseases several of which are disproportionately prevalent, endemic or distinctive to the region. These result in considerable morbidity and mortality, which can be greatly reduced through public‐health measures, timely diagnosis and treatment. Some of these infectious diseases have neurological manifestations including movement disorders either due to the pathogen being neuroinvasive or via an immune‐mediated response. For diseases such as Japanese encephalitis, movement disorders are the primary manifestation while for others, they can be a presenting feature. Thus, recognizing these movement disorders is often crucial to the diagnosis of the particular infection, and/or to exclude infection as a cause and arrive at the correct alternate diagnosis. Once diagnosed, the infection‐related movement disorders are treated by targeting the infectious agent, or symptomatically. In this article, we describe and illustrate a variety of movement disorders that are seen in patients infected by viruses, bacteria and parasites in South Asia. This would be of value to neurologists practicing in the region and, with the increasing ease in movement of people and pathogens, those practicing elsewhere.

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Viral Parkinsonism: An underdiagnosed neurological complication of Dengue virus infection

2022

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Dengue virus (DENV) is a flavivirus that is a significant cause of human disease costing billions of dollars per year in medical and mosquito control costs. It is estimated that up to 20% of DENV infections affect the brain. Incidence of DENV infections is increasing, which suggests more people are at risk of developing neurological complications. The most common neurological manifestations of DENV are encephalitis and encephalopathy, and movement disorders such as parkinsonism have been observed. Parkinsonism describes syndromes similar to Parkinson’s Disease where tremors, stiffness, and slow movements are observed. Parkinsonism caused by viral infection is characterized by patients exhibiting at least two of the following symptoms: tremor, bradykinesia, rigidity, and postural instability. To investigate DENV-associated parkinsonism, case studies and reports of DENV-associated parkinsonism were obtained from peer-reviewed manuscripts and gray literature. Seven reports of clinically diagnosed DENV-associated parkinsonism and 15 cases of DENV encephalitis, where the patient met the case criteria for a diagnosis of viral parkinsonism were found. Clinically diagnosed DENV-associated parkinsonism patients were more likely to be male and exhibit expressionless face, speech problems, and lymphocytosis. Suspected patients were more likely to exhibit tremor, have thrombocytopenia and low hemoglobin. Viral parkinsonism can cause a permanent reduction in neurons with consequential cognitive and behavior changes, or it can leave a latent imprint in the brain that can cause neurological dysfunction decades after recovery. DENV-associated parkinsonism is underdiagnosed and better adherence to the case definition of viral parkinsonism is needed for proper management of potential sequalae especially if the patient has an ongoing or potential to develop a neurodegenerative disease.

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Atypical neurological manifestations of dengue fever: a case series and mini review

Cited by 16 publications

References 16 publications

Autoimmune manifestations in patients with dengue. Casuistry in the Internal Medicine Department of the Hospital Nacional, Paraguay

Autoimmune manifestations in patients with dengue. Casuistry in the Internal Medicine Department of the Hospital Nacional, Paraguay

Video Anthology of Movement Disorders Due to Infections in South Asia

Viral Parkinsonism: An underdiagnosed neurological complication of Dengue virus infection

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