Neurological complications of dengue virus infection.
Dengue is the second most common mosquito-borne disease affecting human beings. In 2009, WHO endorsed new guidelines that, for the first time, consider neurological manifestations in the clinical case classification for severe dengue. Dengue can manifest with a wide range of neurological features, which have been noted--depending on the clinical setting--in 0·5-21% of patients with dengue admitted to hospital. Furthermore, dengue was identified in 4-47% of admissions with encephalitis-like illness in endemic areas. Neurological complications can be categorised into dengue encephalopathy (eg, caused by hepatic failure or metabolic disorders), encephalitis (caused by direct virus invasion), neuromuscular complications (eg, Guillain-Barré syndrome or transient muscle dysfunctions), and neuro-ophthalmic involvement. However, overlap of these categories is possible. In endemic countries and after travel to these regions, dengue should be considered in patients presenting with fever and acute neurological manifestations.
Neurology Department, Raigmore Hospital, Inverness, UK; Medicine and Health Sciences Faculty, Universitat Internacional de Catalunya (UIC), Barcelona, Spain. Electronic address: javier.carodartal@nhs.net.
Francisco Javier
FJ
Carod-Artal
Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
Ole
O
Wichmann
Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Centre for Tropical Medicine, Oxford University, Ho Chi Minh City, Vietnam; Department of Medicine, National University of Singapore, Singapore.
Jeremy
J
Farrar
Barcelona Center for International Health Research (CRESIB), Hospital Clinic-Universitat de Barcelona, Barcelona, Spain.
Joaquim
J
Gascón
D003715:Dengue / Q000150:complications* / Q000175:diagnosis / Q000821:virology*; D018792:Encephalitis, Viral / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D009422:Nervous System Diseases / Q000175:diagnosis / Q000209:etiology* / Q000821:virology*