title: Neurologic manifestations of pediatric chikungunya infection.
abstract: Chikungunya virus, a mosquito-borne arbovirus, was responsible for a massive epidemic in La Réunion Island during 2005 to 2006. The disease is usually benign, but neurologic involvement, with sometimes fatal outcome, has been described. We report a retrospective hospital-based pediatric series of 30 children (23 boys and 7 girls) who presented neurologic manifestations of chikungunya such as encephalitis (n = 12), febrile seizures (n = 10), meningeal syndrome (n = 4), and acute encephalopathy (n = 4). Cerebrospinal fluid biological and cytological analyses (n = 23) were unremarkable except for 1 case of acute disseminated encephalomyelitis. The presence of viral genome in cerebrospinal fluid was inconstantly positive. Brain magnetic resonance imaging (MRI) scans (n = 14) were abnormal in 5 cases. Electroencephalography was nonspecific. Two patients died. At discharge and 6 months later, 5 children had neurologic sequelae. Patients with initial severe neurologic presentation and having pathological brain MRI had more sequelae or fatal disease.
authors.affiliation: Service de Pédiatrie, Centre Hospitalier Départemental Félix Guyon, La Réunion, France. st-robin@chd-fguyon.fr
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Robin
authors.forename: Duksha
authors.initials: D
authors.lastname: Ramful
authors.forename: Florence
authors.initials: F
authors.lastname: Le Seach'
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Jaffar-Bandjee
authors.forename: Gérald
authors.initials: G
authors.lastname: Rigou
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Alessandri
mesh_terms: D000293:Adolescent; D000367:Age Factors; D017668:Age of Onset; D001921:Brain / Q000473:pathology / Q000821:virology; D002646:Chikungunya virus / Q000235:genetics / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D003244:Consciousness Disorders / Q000821:virology; D004453:Echoencephalography; D004569:Electroencephalography; D004671:Encephalitis, Arbovirus / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006261:Headache / Q000821:virology; D006801:Humans; D007195:Indian Ocean Islands; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D008587:Meningitis, Viral / Q000175:diagnosis* / Q000503:physiopathology* / Q000821:virology; D012367:RNA, Viral / Q000235:genetics / Q000302:isolation & purification; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction
chemical_list: D012367:RNA, Viral