Spectrum of Neuromuscular Manifestations in Dengue: A Systematic Review of Case Reports and Case Series.

BACKGROUND AND

OBJECTIVES

While the systemic features of dengue are well-documented, its neuromuscular manifestations remain under-characterized. We aimed to systematically review the published literature on the spectrum, clinical features, diagnostics, management, and outcomes of neuromuscular complications associated with dengue infection.

METHODS

A comprehensive literature search was conducted in PubMed, Embase, Scopus, and Google Scholar up to March 9, 2025. Case reports, case series, and observational studies reporting individual-level data on dengue-associated neuromuscular complications were included. Data extraction and quality assessment were performed independently by multiple reviewers, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework was followed. The protocol was registered with PROSPERO (Registration ID: CRD420251008871).

RESULTS

A total of 137 articles describing 171 individual patient cases were included. Guillain-Barré syndrome (n = 57), myositis/myopathy (n = 38), rhabdomyolysis (n = 24), and hypokalemia-induced paralysis (n = 31) were the most commonly reported manifestations. Less frequent complications included mononeuropathies, radiculopathy/plexopathy, and neuromuscular junction disorders. Most cases were reported from South and Southeast Asia. The majority of patients responded well to supportive or immunomodulatory therapies. The overall prognosis was favorable, with full or near-complete recovery in most cases.

CONCLUSIONS

Dengue can cause a wide range of neuromuscular complications, often requiring early recognition and targeted management. Clinicians should be aware of these manifestations, especially in endemic regions.