title: Guillain-Barre syndrome complicating chikungunya virus infection.
abstract: Chikungunya virus (CHIKV) is a mosquito-borne alphavirus which presents with symptoms of fever, rash, arthralgia, and occasional neurologic disease. While outbreaks have been earlier reported from India and other parts of the world, the recent outbreak in India witnessed more than 1000 cases. Various systemic and rarely neurological complications have been reported with CHIKV. We report two cases of Guillain-Barré syndrome (GBS) with CHIKV. GBS is a rare neurological complication which may occur after subsidence of fever and constitutional symptoms by several neurotropic viruses. We describe two cases of severe GBS which presented with rapidly progressive flaccid quadriparesis progressing to difficulty in swallowing and breathing. Both required mechanical ventilation and improved partly with plasmapharesis. The cases emphasize on (1) description of the rare complication in a setting of outbreak with CHIKV, (2) acute axonal as well as demyelinating neuropathy may occur with CHIKV, (3) accurate identification of this entity during outbreaks with dengue, both of which are vector borne and may present with similar complications.
authors.affiliation: Neurosciences Center, Department of Neurology, All India Institute of Medical Sciences, Room number 707, 7th floor, New Delhi, India.
authors.forename: Ayush
authors.initials: A
authors.lastname: Agarwal
authors.affiliation: Neurosciences Center, Department of Neurology, All India Institute of Medical Sciences, Room number 707, 7th floor, New Delhi, India. deeptivibha@gmail.com.
authors.forename: Deepti
authors.identifier: 0000-0003-3659-7526
authors.initials: D
authors.lastname: Vibha
authors.affiliation: Neurosciences Center, Department of Neurology, All India Institute of Medical Sciences, Room number 707, 7th floor, New Delhi, India.
authors.forename: Achal Kumar
authors.initials: AK
authors.lastname: Srivastava
authors.affiliation: Neurosciences Center, Department of Neurology, All India Institute of Medical Sciences, Room number 707, 7th floor, New Delhi, India.
authors.forename: Garima
authors.initials: G
authors.lastname: Shukla
authors.affiliation: Neurosciences Center, Department of Neurology, All India Institute of Medical Sciences, Room number 707, 7th floor, New Delhi, India.
authors.forename: Kameshwar
authors.initials: K
authors.lastname: Prasad
mesh_terms: D000293:Adolescent; D000328:Adult; D065632:Chikungunya Fever / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D002646:Chikungunya virus / Q000472:pathogenicity* / Q000502:physiology; D020275:Guillain-Barre Syndrome / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D010956:Plasmapheresis / Q000379:methods*; D011782:Quadriplegia / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D012121:Respiration, Artificial; D016896:Treatment Outcome
keywords: Chikungunya virus; Guillain-Barre syndrome; Mosquito-borne diseases; Plasmapharesis