Neurological complications in Chikungunya infection

Chandak, Nitin H.; Kashyap, Rajpal S.; Taori, Girdhar M.; Daginawala, Hatim F.

doi:10.1186/1753-6561-2-s1-p11

Cited by 18 publications

(28 citation statements)

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“…The lowest plasma sodium level was recorded on the day of the onset of coma. The onset of neurological symptoms has been reported to occur early within 2-3 days 5 or after weeks of the onset of the disease 6 .…”

Section: Discussionmentioning

confidence: 99%

“…A common finding in patients with CHIKV infection is the increase in creatine phosphokinase (CPK) levels (CPK=2,272U/L; reference 26 -192U/L), due to intense myositis caused by the infection 6 . Liver enzymes levels were also increased in this case.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with encephalitis may have normal CSF or, more frequently, increased protein levels, and increased cellularity in a few cases 5,6 . Chandak et al reported increased protein levels in 14 out of 20 patients with encephalitis, low glucose levels in 3, and increased cellularity in 6 cases 6 .…”

Section: Discussionmentioning

confidence: 99%

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Encephalitis associated with inappropriate antidiuretic hormone secretion due to chikungunya infection in Recife, State of Pernambuco, Brazil

Lucena‐Silva

Assunção

Ramos

et al. 2017

Rev. Soc. Bras. Med. Trop.

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The symptoms of chikungunya virus (CHIKV) infection include fever, headache, muscle aches, skin rash, and polyarthralgia, characterized by intense pain, edema, and temporary functional impairment. This is the first report of encephalitis caused by CHIKV infection associated with an atypical presentation of syndrome of inappropriate antidiuretic hormone secretion, evolving to cognitive impairment and apraxia of speech.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Encephalitis associated with inappropriate antidiuretic hormone secretion due to chikungunya infection in Recife, State of Pernambuco, Brazil

Lucena‐Silva

Assunção

Ramos

et al. 2017

Rev. Soc. Bras. Med. Trop.

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“…There are also reported neurologic complications, including meningoencephalitis, myelitis, and Guillain-Barré syndrome. In a retrospective study following a 2006 outbreak in western India, Chandak et al [43] reported that 49 of 300 (16 %) patients had neurological complications, including over half with encephalitis and the remaining with myelopathy, peripheral neuropathy, and myeloneuropathy.…”

Section: Vaccines Under Development For Zoonotic Alphaviruses Encephamentioning

confidence: 99%

Vaccinations for Neuroinfectious Disease: A Global Health Priority

Leibovitch

Jacobson

2016

Neurotherapeutics

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Vaccines for neuroinfectious diseases are becoming an ever-increasing global health priority, as neurologic manifestations and sequelae from existing and emerging central nervous system infections account for significant worldwide morbidity and mortality. The prevention of neurotropic infections can be achieved through globally coordinated vaccination campaigns, which have successfully eradicated nonzoonotic agents such as the variola viruses and, hopefully soon, poliovirus. This review discusses vaccines that are currently available or under development for zoonotic flaviviruses and alphaviruses, including Japanese and tick-borne encephalitis, yellow fever, West Nile, dengue, Zika, encephalitic equine viruses, and chikungunya. Also discussed are nonzoonotic agents, including measles and human herpesviruses, as well as select bacterial, fungal, and protozoal pathogens. While therapeutic vaccines will be required to treat a multitude of ongoing infections of the nervous system, the ideal vaccination strategy is preexposure vaccination, with the ultimate goals of minimizing disease associated with zoonotic viruses and the total eradication of nonzoonotic agents.

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“…Alphaviruses are mosquito-borne plus-strandenveloped RNA viruses that cause both encephalomyelitis (Venezuelan, western and eastern equine encephalitis viruses) and arthritis (Sindbis, Ross River, and Chikungunya viruses). The encephalitic alphaviruses are endemic in the Americas, while the rapidly emerging arthritic alphaviruses that can also cause neurologic disease are now found worldwide [2,[4][5][6][7]. Currently, there are no treatments or vaccines licensed for these infections.…”

Section: Introductionmentioning

confidence: 99%

Alphavirus Encephalomyelitis: Mechanisms and Approaches to Prevention of Neuronal Damage

Griffin

2016

Neurotherapeutics

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Mosquito-borne viruses are important causes of death and long-term neurologic disability due to encephalomyelitis. Studies of mice infected with the alphavirus Sindbis virus have shown that outcome is dependent on the age and genetic background of the mouse and virulence of the infecting virus. Agedependent susceptibility reflects the acquisition by neurons of resistance to virus replication and virus-induced cell death with maturation. In mature mice, the populations of neurons most susceptible to infection are in the hippocampus and anterior horn of the spinal cord. Hippocampal infection leads to long-term memory deficits in mice that survive, while motor neuron infection can lead to paralysis and death. Neuronal death is immune-mediated, rather than a direct consequence of virus infection, and associated with entry and differentiation of pathogenic T helper 17 cells in the nervous system. To modulate glutamate excitotoxicity, mice were treated with an N-methyl-D-aspartate receptor antagonist, α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor antagonists or a glutamine antagonist. The N-methyl-D-aspartate receptor antagonist MK-801 protected hippocampal neurons but not motor neurons, and mice still became paralyzed and died. α-Amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor antagonists GYKI-52466 and talampanel protected both hippocampal and motor neurons and prevented paralysis and death. Glutamine antagonist 6-diazo-5-l-norleucine protected hippocampal neurons and improved memory generation in mice surviving infection with an avirulent virus. Surprisingly, in all cases protection was associated with inhibition of the antiviral immune response, reduced entry of inflammatory cells into the central nervous system, and delayed virus clearance, emphasizing the importance of treatment approaches that include prevention of immunopathologic damage.

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Neurological complications in Chikungunya infection

Cited by 18 publications

References 0 publications

Encephalitis associated with inappropriate antidiuretic hormone secretion due to chikungunya infection in Recife, State of Pernambuco, Brazil

Encephalitis associated with inappropriate antidiuretic hormone secretion due to chikungunya infection in Recife, State of Pernambuco, Brazil

Vaccinations for Neuroinfectious Disease: A Global Health Priority

Alphavirus Encephalomyelitis: Mechanisms and Approaches to Prevention of Neuronal Damage

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