Neurological manifestations of dengue: a cross sectional study.

BACKGROUND

Dengue is an infectious disease caused by a virus of the flaviviridae family. It is a multi systemic illness causing considerable morbidity and mortality. A spectrum of neurological manifestations has been associated with dengue.

METHODS

This was a descriptive cross sectional study including patients diagnosed with Dengue fever (DF), Dengue with warning signs and severe dengue with neurological sequale presenting to the Institute of Neurology, National Hospital of Sri Lanka from June 2011 to August 2012. All patients underwent serology testing for Dengue IgM in blood and CSF as confirmation of the diagnosis.

RESULTS

Seven patients were included. 1/7 had bilateral optic neuritis (ON), 3/7 had a cerebellar syndrome (CS), 2/7 had transverse myelitis (TM) and 1/7 had cranial nerve palsy. The patient with ON had a post-infectious pattern and protracted recovery. All patients with CS had bilateral involvement. All had a self limiting course with complete recovery. Two were associated with acute infection. Both patients with TM had longitudinally extensive disease with one patient experiencing complete recovery. The patient with cranial nerve involvement had isolated 6th nerve palsy.

CONCLUSIONS

Neurological manifestations of dengue are diverse. It is important to consider dengue as a cause for the above neurological presentations in hyper endemic territories for the disease.