Clinical and magnetic resonance imaging patterns of extensive Chikungunya virus–associated myelitis

Rueda-Lopes, Fernanda Cristina; Cruz, Luiz Celso Hygino da; Fontes, Fabrícia Lima; Herlinger, Alice Laschuk; Ferreira, Orlando da Costa; Aguiar, Renato Santana; Vasconcelos, Cláudia Cristina Ferreira; Nascimento, Osvaldo J. M.; Alves-Leon, Soniza Vieira

doi:10.1007/s13365-021-00962-4

Cited by 13 publications

(8 citation statements)

References 26 publications

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“…She was treated with methylprednisolone and plasmapheresis and recovered arm movements after 1 month. A peripheral pattern of longitudinally extensive myelopathy has been reported in Chikungunya 1 . Circumferential myelopathy sparing the central gray matter has not been consistently reported in other infectious myelitis 2 .…”

Section: Contributionsmentioning

confidence: 93%

“…Circumferential myelopathy sparing the central gray matter has not been consistently reported in other infectious myelitis 2 . Presence of the virus has been demonstrated in perivascular spaces, which might explain the predominance of lesions along perivascular distributions 1 .…”

Section: Contributionsmentioning

confidence: 99%

“…2 Presence of the virus has been demonstrated in perivascular spaces, which might explain the predominance of lesions along perivascular distributions. 1…”

mentioning

confidence: 99%

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“Glass Eel” Sign in Chikungunya Myelopathy

et al. 2023

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Section: Contributionsmentioning

confidence: 93%

Section: Contributionsmentioning

confidence: 99%

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“Glass Eel” Sign in Chikungunya Myelopathy

et al. 2023

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“…MRI of the spinal cord in affected patients shows multiple punctate and longitudinal T2 hyperintense lesions with associated T1 contrast enhancement, primarily in the peripheral regions of the spinal cord. 40 In acute settings (the first week of symptoms), chikungunya is diagnosed by reverse transcription PCR of viral RNA from blood. After the first week, serologic testing by IgM and IgG is KEY POINTS…”

Section: Commentmentioning

confidence: 99%

“…Whether these represent direct neurotropism or likely secondary immune response is unclear. MRI of the spinal cord in affected patients shows multiple punctate and longitudinal T2 hyperintense lesions with associated T1 contrast enhancement, primarily in the peripheral regions of the spinal cord 40 . In acute settings (the first week of symptoms), chikungunya is diagnosed by reverse transcription PCR of viral RNA from blood.…”

Section: Viral Myelopathiesmentioning

confidence: 99%

Infectious Myelopathies

Fletcher,

Bhattacharyya

2024

CONTINUUM: Lifelong Learning in Neurology

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Objective Infectious myelopathy of any stage and etiology carries the potential for significant morbidity and mortality. This article details the clinical presentation, risk factors, and key diagnostic components of infectious myelopathies with the goal of improving the recognition of these disorders and guiding subsequent management. Latest Developments Despite our era of advanced multimodal imaging and laboratory diagnostic technology, a causative organism often remains unidentified in suspected infectious and parainfectious myelopathy cases. To improve diagnostic capability, newer technologies such as metagenomics are being harnessed to develop diagnostic assays with a greater breadth of data from each specimen and improvements in infection identification. Conventional assays have been optimized for improved sensitivity and specificity. Essential Points Prompt recognition and treatment of infectious myelopathy decreases morbidity and mortality. The key diagnostic tools include serologies, CSF analysis, and imaging; however clinical presentation, epidemiologic risk factors, and history of recent illness are all vital to making the proper diagnosis because current laboratory and imaging modalities are often inconclusive. The cornerstone of recommended treatment is targeted antimicrobials with appropriate immune modulation, surgical intervention, supportive care, and interdisciplinary involvement, all of which further improve outcomes for patients with infectious myelopathy.

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Chikungunya Encephalitis: an Inconsistently Reported Headache and Cause of Death in Patients with Pre-Existing Conditions

2022

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Chikungunya virus (CHIKV) is an alphavirus of the family Togaviridae with outbreaks occurring across Africa, Asia, parts of Europe, and South and Central America. There are three main lineages of CHIKV, including the West African lineage, the East Central South African (ECSA) lineage, and the Asian lineage. While CHIKV infection usually results in a self-limited febrile illness, there have been reports of concerning neurological manifestations, including encephalitis. Herein we discuss findings of over 700 cases of CHIKV encephalitis and risk factors for death. Additionally, we examined the genotypes of CHIKV associated with encephalitis and found that both the Asian and ECSA lineages were responsible for encephalitis but not the West African lineage. Protein analysis of consensus sequences of CHIKV strains associated with encephalitis identified mutations in the nsP1, nsP2, and nsP3 proteins. Reports and manuscripts of CHIKV encephalitis were inconsistent in reporting viral, demographic, and clinical features which complicated the delineation of risk factors associated with the disease and viral evolution. As climate change contributes to the range expansion of natural vectors, it is important for researchers and clinicians to consistently report patient and viral data to facilitate research and countermeasures for the ecology and epidemiology of CHIKV due to the lack of a targeted treatment or vaccine.

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Clinical and magnetic resonance imaging patterns of extensive Chikungunya virus–associated myelitis

Cited by 13 publications

References 26 publications

“Glass Eel” Sign in Chikungunya Myelopathy

“Glass Eel” Sign in Chikungunya Myelopathy

Infectious Myelopathies

Chikungunya Encephalitis: an Inconsistently Reported Headache and Cause of Death in Patients with Pre-Existing Conditions

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