title: Neurologic complications in dengue virus infection: a prospective cohort study.
abstract: OBJECTIVE
  This study aimed to evaluate the incidence and clinical spectrum of neurologic complications, predictors of central and peripheral nervous system involvement, and their outcome in patients with dengue virus infection (DENV).
  
  
  METHODS
  To determine the extent of neurologic complications, we used a hospital-based prospective cohort study design, which included laboratory-confirmed cases of dengue and follow-up for 3 months. We also analyzed clinical and laboratory data to assess predictors of neurologic involvement.
  
  
  RESULTS
  The study included enrollment of 486 cases. Two were lost to follow-up and excluded. Forty-five patients developed neurologic complications. Of these, 28 patients had CNS and 17 had peripheral nervous system (PNS) involvement, representing an incidence rate for neurologic complications of 9.26%. Significant predictors of CNS involvement were higher mean body temperature (p = 0.012), elevated hematocrit (p = 0.009), low platelet count (p = 0.021), and liver dysfunction (p < 0.001). Predictors of PNS involvement were higher mean body temperature (p = 0.031), rash (p = 0.002), and elevated hematocrit (p < 0.001). The mortality rate was 4.5%. The remainder of the patients recovered.
  
  
  CONCLUSIONS
  An increasingly wide spectrum and higher incidence of neurologic complications of DENV are reported. Clinical and laboratory parameters such as higher mean body temperature, rash, increases in hematocrit, thrombocytopenia, and liver dysfunction are independent predictors of neurologic complications.
authors.affiliation: From the Departments of Neurology (R.S., R.V., R.K.G., M.K.S., H.S.M., P.K.S.), Microbiology (A.J.), and Radiodiagnosis (A.P.), King George's Medical University, Lucknow, India.
authors.forename: Ritesh
authors.initials: R
authors.lastname: Sahu
authors.affiliation: From the Departments of Neurology (R.S., R.V., R.K.G., M.K.S., H.S.M., P.K.S.), Microbiology (A.J.), and Radiodiagnosis (A.P.), King George's Medical University, Lucknow, India. drrajeshverma32@yahoo.com.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Verma
authors.affiliation: From the Departments of Neurology (R.S., R.V., R.K.G., M.K.S., H.S.M., P.K.S.), Microbiology (A.J.), and Radiodiagnosis (A.P.), King George's Medical University, Lucknow, India.
authors.forename: Amita
authors.initials: A
authors.lastname: Jain
authors.affiliation: From the Departments of Neurology (R.S., R.V., R.K.G., M.K.S., H.S.M., P.K.S.), Microbiology (A.J.), and Radiodiagnosis (A.P.), King George's Medical University, Lucknow, India.
authors.forename: Ravindra K
authors.initials: RK
authors.lastname: Garg
authors.affiliation: From the Departments of Neurology (R.S., R.V., R.K.G., M.K.S., H.S.M., P.K.S.), Microbiology (A.J.), and Radiodiagnosis (A.P.), King George's Medical University, Lucknow, India.
authors.forename: Maneesh K
authors.initials: MK
authors.lastname: Singh
authors.affiliation: From the Departments of Neurology (R.S., R.V., R.K.G., M.K.S., H.S.M., P.K.S.), Microbiology (A.J.), and Radiodiagnosis (A.P.), King George's Medical University, Lucknow, India.
authors.forename: Hardeep S
authors.initials: HS
authors.lastname: Malhotra
authors.affiliation: From the Departments of Neurology (R.S., R.V., R.K.G., M.K.S., H.S.M., P.K.S.), Microbiology (A.J.), and Radiodiagnosis (A.P.), King George's Medical University, Lucknow, India.
authors.forename: Praveen K
authors.initials: PK
authors.lastname: Sharma
authors.affiliation: From the Departments of Neurology (R.S., R.V., R.K.G., M.K.S., H.S.M., P.K.S.), Microbiology (A.J.), and Radiodiagnosis (A.P.), King George's Medical University, Lucknow, India.
authors.forename: Anit
authors.initials: A
authors.lastname: Parihar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002493:Central Nervous System Diseases / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D003715:Dengue / Q000150:complications / Q000453:epidemiology / Q000401:mortality; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D011379:Prognosis; D011446:Prospective Studies; D055815:Young Adult