Atypical neurological manifestations of dengue fever: a case series and mini review

BackgroundIn this mini review, we discuss some of the atypical neurological manifestations of dengue virus and attempt to bring them to attention to highlight the neurotropic property of the dengue virus.MethodsCases were chosen from retrospective hospital and outpatient records of all patients seropositive for dengue who attended the neurology referral. Seven patients have been chosen as illustrative examples of dengue-associated neurological involvement. We discuss the various central and peripheral nervous system involvement of patients and discuss the relevant findings in them.ConclusionThrough this case series, we wish to highlight that the dengue virus can affect the nervous system at various targets, using multiple mechanisms of pathogenesis to generate a plethora of presentations. Hence, it is vital to be aware of its presentations to be able to diagnose dengue and treat it accordingly.

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Central and peripheral nervous system involvement by COVID-19: A systematic review of the pathophysiology, clinical manifestations, neuropathology, neuroimaging, electrophysiology, and cerebrospinal fluid findings

10.21203/rs.3.rs-105950/v1 ◽

2020 ◽

Author(s):

Juan I. Guerrero ◽

Luis A. Barragán ◽

Juan D. Martínez ◽

Juan P. Montoya ◽

Alejandra Peña ◽

...

Keyword(s):

Systematic Review ◽

Cerebrospinal Fluid ◽

Nervous System ◽

Peripheral Nervous System ◽

Evidence Synthesis ◽

Clinical Manifestations ◽

Neurological Impairment ◽

Neurological Involvement ◽

Categorical Analysis ◽

System Involvement

Abstract Background: SARS-CoV-2 can affect the human brain and other neurological structures. An increasing number of publications report neurological manifestations in patients with COVID-19. However, no studies have comprehensively reviewed the clinical and paraclinical characteristics of the central and peripheral nervous system's involvement in these patients. This study aimed to describe the features of the central and peripheral nervous system involvement by COVID-19 in terms of pathophysiology, clinical manifestations, neuropathology, neuroimaging, electrophysiology, and cerebrospinal fluid findings.Methods: We conducted a comprehensive systematic review of all the original studies reporting patients with neurological involvement by COVID-19, from December 2019 to June 2020, without language restriction. We excluded studies with animal subjects, studies not related to the nervous system, and opinion articles. Data analysis combined descriptive measures, frequency measures, central tendency measures, and dispersion measures for all studies reporting neurological conditions and abnormal ancillary tests in patients with confirmed COVID-19.Results: A total of 143 observational and descriptive studies reported central and peripheral nervous system involvement by COVID-19 in 10723 patients. Fifty-one studies described pathophysiologic mechanisms of neurological involvement by COVID-19, 119 focused on clinical manifestations, 4 described neuropathology findings, 62 described neuroimaging findings, 28 electrophysiology findings, and 60 studies reported cerebrospinal fluid results. The reviewed studies reflect a significant prevalence of the nervous system's involvement in patients with COVID-19, ranging from 22.5% to 36.4% among different studies, without mortality rates explicitly associated with neurological involvement by SARS-COV-2. We thoroughly describe the clinical and paraclinical characteristics of neurological involvement in these patients. Conclusions: Our evidence synthesis led to a categorical analysis of the central and peripheral involvement by COVID-19 and provided a comprehensive explanation of the reported pathophysiological mechanisms by which SARS-CoV-2 infection may cause neurological impairment. International collaborative efforts and exhaustive neurological registries will enhance the translational knowledge of COVID-19's CNS and PNS involvement and generate strategies for therapeutic decision-making.Registration: This review is registered in PROSPERO (CRD42020193140), July 24, 2020.

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Central and peripheral nervous system involvement by COVID-19: a systematic review of the pathophysiology, clinical manifestations, neuropathology, neuroimaging, electrophysiology, and cerebrospinal fluid findings

BMC Infectious Diseases ◽

10.1186/s12879-021-06185-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Juan I. Guerrero ◽

Luis A. Barragán ◽

Juan D. Martínez ◽

Juan P. Montoya ◽

Alejandra Peña ◽

...

Keyword(s):

Systematic Review ◽

Cerebrospinal Fluid ◽

Nervous System ◽

Peripheral Nervous System ◽

Evidence Synthesis ◽

Clinical Manifestations ◽

Neurological Impairment ◽

Neurological Involvement ◽

Categorical Analysis ◽

System Involvement

Abstract Background SARS-CoV-2 can affect the human brain and other neurological structures. An increasing number of publications report neurological manifestations in patients with COVID-19. However, no studies have comprehensively reviewed the clinical and paraclinical characteristics of the central and peripheral nervous system’s involvement in these patients. This study aimed to describe the features of the central and peripheral nervous system involvement by COVID-19 in terms of pathophysiology, clinical manifestations, neuropathology, neuroimaging, electrophysiology, and cerebrospinal fluid findings. Methods We conducted a comprehensive systematic review of all the original studies reporting patients with neurological involvement by COVID-19, from December 2019 to June 2020, without language restriction. We excluded studies with animal subjects, studies not related to the nervous system, and opinion articles. Data analysis combined descriptive measures, frequency measures, central tendency measures, and dispersion measures for all studies reporting neurological conditions and abnormal ancillary tests in patients with confirmed COVID-19. Results A total of 143 observational and descriptive studies reported central and peripheral nervous system involvement by COVID-19 in 10,723 patients. Fifty-one studies described pathophysiologic mechanisms of neurological involvement by COVID-19, 119 focused on clinical manifestations, 4 described neuropathology findings, 62 described neuroimaging findings, 28 electrophysiology findings, and 60 studies reported cerebrospinal fluid results. The reviewed studies reflect a significant prevalence of the nervous system’s involvement in patients with COVID-19, ranging from 22.5 to 36.4% among different studies, without mortality rates explicitly associated with neurological involvement by SARS-CoV-2. We thoroughly describe the clinical and paraclinical characteristics of neurological involvement in these patients. Conclusions Our evidence synthesis led to a categorical analysis of the central and peripheral neurological involvement by COVID-19 and provided a comprehensive explanation of the reported pathophysiological mechanisms by which SARS-CoV-2 infection may cause neurological impairment. International collaborative efforts and exhaustive neurological registries will enhance the translational knowledge of COVID-19’s central and peripheral neurological involvement and generate therapeutic decision-making strategies. Registration This review was registered in PROSPERO 2020 CRD42020193140 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020193140

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Neurological manifestations and pathophysiological mechanisms of Covid-19

ARCHIVES OF HEALTH INVESTIGATION ◽

10.21270/archi.v10i7.5460 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1040-1047

Author(s):

Cristiano Gaujac ◽

Regiane Cristina Amaral

Keyword(s):

Nervous System ◽

Severe Acute Respiratory Syndrome ◽

Literature Review ◽

Peripheral Nervous System ◽

Etiologic Agent ◽

Neurological Involvement ◽

Neurological Manifestations ◽

Pathophysiological Mechanisms ◽

Life Threatening ◽

The Relationship

Background - Severe acute respiratory syndrome coronavirus-2 is a novel, highly infectious coronavirus and the etiologic agent of Covid-19. The course of Covid-19 can range from mild flu-like symptoms to severe, life-threatening symptoms, especially when comorbidities are present. Increasing studies have reinforced the association between SARS-CoV-2 and various neurological manifestations, although the pathophysiological mechanisms remain uncertain. Objective - The aim of this paper was to briefly describe current findings on the relationship between SARS-CoV-2 pathophysiology and major CNS and Peripheral Nervous System (PNS) manifestations. Methods and Material - This work consists of a literature review based on the study of academic papers. To this end, the Pubmed platform was used to search for scientific articles, using the keywords: covid-19, coronavirus, physiopathology, neuronal symptoms. Results - out of 114,660 articles found, 94 were selected for this review. Conclusions - Periodic reviews collaborate in the constant updating and summarization of findings. Understanding the pathophysiology of SARS-CoV-2 on the SN and the link between the systems may lead to earlier and earlier diagnoses of neurological involvement, guide therapeutic management, prevent sequelae, and preserve lives.

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Paracoccidioidomycosis case series with and without central nervous system involvement

Revista da Sociedade Brasileira de Medicina Tropical ◽

10.1590/s0037-86822012000500009 ◽

2012 ◽

Vol 45 (5) ◽

pp. 586-590 ◽

Cited By ~ 10

Author(s):

Vinicius Sousa Pietra Pedroso ◽

Ana Claudia Lyon ◽

Stanley Almeida Araújo ◽

Juliana Márcia Ribeiro Veloso ◽

Enio Roberto Pietra Pedroso ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Family History ◽

Clinical Laboratory ◽

Central Nervous System Involvement ◽

Case Series ◽

Minas Gerais ◽

University Hospital ◽

Neurological Involvement ◽

System Involvement

INTRODUCTION: Paracoccidioidomycosis (PCM) is the most important systemic mycosis in South America. Central nervous system involvement is potentially fatal and can occur in 12.5% of cases. This paper aims to contribute to the literature describing eight cases of neuroparacoccidioidomycosis (NPMC) and compare their characteristics with patients without neurological involvement, to identify unique characteristics of NPCM. METHODS: A cohort of 213 PCM cases was evaluated at the Infectious Diseases Clinic of the University Hospital, Federal University of Minas Gerais, Brazil, from October 1976 to August 2008. Epidemiological, clinical, laboratory, therapeutic and follow-up data were registered. RESULTS: Eight patients presented NPCM. The observed NPCM prevalence was 3.8%. One patient presented the subacute form of PCM and the other seven presented the chronic form of the disease. The parenchymatous form of NPCM occurred in all patients. 60% of the patients who proceeded from the north/ northeast region of Minas Gerais State developed NPCM. The neurological involvement of a mother and her son was observed. NPCM patients exhibited demographical and clinical profiles similar to what is described in the literature. When NPCM cases were compared to PCM patients, there were differences in relation to origin and positive PCM family history. CONCLUSIONS: The results corroborate the clinical view that the neurological findings are extremely important in the evaluation of PCM patients. Despite the limitations of this study, the differences in relation to patient's origins and family history point to the need of further studies to determine the susceptibility factors involved in the neurological compromise.

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Dengue Fever and Neurology: Well Beyond Hemorrhage and Strokes

10.20944/preprints202005.0421.v1 ◽

2020 ◽

Author(s):

Marco Antônio Machado Schlindwein ◽

Isabelle Pastor Bandeira ◽

Letícia Caroline Breis ◽

Júlia Machado Rickli ◽

Caio César Demore ◽

...

Keyword(s):

Nervous System ◽

Dengue Virus ◽

Dengue Fever ◽

Neurological Complications ◽

The Body ◽

Common Disease ◽

Neurological Manifestations ◽

Immune Mediated

Dengue virus an arbovirus is endemic in an area that comprise almost half of the world's population, contrary to past beliefs that dengue virus differentiate from other neuroinvasive arbovirus due to its lack of neurological invasion and disease related neurological complications excluding hemorrhagic and thromboembolic , the body of evidence have grown to demonstrate a series of neurological manifestations linked to dengue virus with possible mechanisms involving direct virus invasion of the nervous system or immune mediated complications. In this review we provide a wide approach to this neglect but not so rare manifestations of a very common disease.

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Leptospirosis presenting as acute meningoencephalitis

The Journal of Infection in Developing Countries ◽

10.3855/jidc.646 ◽

2010 ◽

Vol 4 (03) ◽

pp. 179-182 ◽

Cited By ~ 7

Author(s):

Sanjeev Jha ◽

Mohd Khateebullah Ansari

Keyword(s):

Nervous System ◽

Hepatic Encephalopathy ◽

Cerebral Malaria ◽

Dengue Fever ◽

Tuberculous Meningitis ◽

Viral Encephalitis ◽

Neurological Manifestations ◽

Significant Morbidity ◽

System Involvement ◽

Neurological Features

Leptospirosis in humans is a common zoonotic disease. It is often under-diagnosed, especially when associated with neurological features, resulting in significant morbidity and mortality. This subgroup of patients with neurological manifestations is often empirically treated for cerebral malaria, dengue fever, tuberculous meningitis, hepatic encephalopathy, viral encephalitis, etc. Hence it is important to be aware of uncommon manifestations of this disease. We report one such patient, which highlights the importance of considering leptospirosis as the diagnostic possibility with hepato-renal, pulmonary and nervous system involvement, particularly where diagnostic supports and resources are limited.

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Acute disseminated encephalomyelitis with peripheral nervous system involvement in an adult following measles: a case report and review of literature

Medical Engineering and Bioinformatics ◽

10.2495/meb140861 ◽

2014 ◽

Author(s):

Ying Zhang ◽

Panpan Zhao ◽

Huiyi Jiang ◽

Li Sun

Keyword(s):

Nervous System ◽

Case Report ◽

Peripheral Nervous System ◽

Acute Disseminated Encephalomyelitis ◽

Review Of Literature ◽

System Involvement

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Polyneuropathy following COVID-19 infection: the rehabilitation approach

BMJ Case Reports ◽

10.1136/bcr-2021-242330 ◽

2021 ◽

Vol 14 (5) ◽

pp. e242330

Author(s):

Ahmad Saif ◽

Anton Pick

Keyword(s):

Nervous System ◽

Critical Illness ◽

Peripheral Nervous System ◽

Upper Limb ◽

Inflammatory Disease ◽

Pathological Process ◽

Neurological Manifestations ◽

Sensorimotor Polyneuropathy ◽

System Disease ◽

Symmetrical Pattern

A range of neurological manifestations associated with COVID-19 have been reported in the literature, but the pathogenesis of these have yet to be fully explained. The majority of cases of peripheral nervous system disease published thus far have shown a symmetrical pattern. In contrast, we describe the case of a patient with asymmetrical predominantly upper-limb sensorimotor polyneuropathy following COVID-19 infection, likely due to a multifactorial pathological process involving critical illness neuropathy, mechanical injury and inflammatory disease. His presentation, management and recovery contribute to the understanding of this complex condition and informs rehabilitation approaches.

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