scholarly journals Dengue: a new challenge for neurology

2012 ◽  
Vol 4 (3) ◽  
pp. 15 ◽  
Author(s):  
Marzia Puccioni-Sohler ◽  
Marco Orsini ◽  
Cristiane N. Soares
Keyword(s):  
Dengue Infection ◽  
Hemorrhagic Fever ◽  
Acute Disseminated Encephalomyelitis ◽  
Neurological Complications ◽  
Immunoglobulin M ◽  
Neurological Manifestations ◽  
Dengue Vaccine ◽  
Autoimmune Reaction ◽  
Viral Antigens ◽  
The World

Dengue infection is a leading cause of illness and death in tropical and subtropical regions of the world. Forty percent of the world’s population currently lives in these areas. The clinical picture resulting from dengue infection can range from relatively minor to catastrophic hemorrhagic fever. Recently, reports have increased of neurological manifestations. Neuropathogenesis seems to be related to direct nervous system viral invasion, autoimmune reaction, metabolic and hemorrhagic disturbance. Neurological manifestations include encephalitis, encephalopathy, meningitis, Guillain-Barré syndrome, myelitis, acute disseminated encephalomyelitis, polyneuropathy, mononeuropathy, and cerebromeningeal hemorrhage. The development of neurological symptoms in patients with positive Immunoglobulin M (IgM) dengue serology suggests a means of diagnosing the neurological complications associated with dengue. Viral antigens, specific IgM antibodies, and the intrathecal synthesis of dengue antibodies have been successfully detected in cerebrospinal fluid. However, despite diagnostic advancements, the treatment of neurological dengue is problematic. The launch of a dengue vaccine is expected to be beneficial.

scholarly journals Advances and new insights in the neuropathogenesis of dengue infection

2015 ◽  
Vol 73 (8) ◽  
pp. 698-703 ◽  
Author(s):  
Marzia Puccioni-Sohler ◽  
Carolina Rosadas
Keyword(s):  
Animal Model ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Dengue Virus ◽  
Murine Model ◽  
Vaccine Development ◽  
Dengue Infection ◽  
Neurological Complications ◽  
Neurological Manifestations ◽  
Viral Antigens

Dengue virus (DENV) infects approximately 390 million persons every year in more than 100 countries. Reports of neurological complications are more frequently. The objective of this narrative review is to bring up the advances in the dengue neuropathogenesis. DENV can access the nervous system through blood-brain barrier disturbance mediated by cytokine. The blood-cerebrospinal fluid (CSF) barrier seems to be also involved, considering the presence of the virus in the CSF of patients with neurological manifestations. As for neurotropism, several studies showed the presence of RNA and viral antigens in brain tissue and CSF in humans. In murine model, different virus mutations were associated to neurovirulence. Despite the advances in the dengue neuropathogenesis, it is still necessary to determine a more appropriate animal model and increase the number of cases of autopsy. The detection of neurovirulence markers may contribute to establish a prognosis, the disease control and vaccine development.

scholarly journals Neurologic Manifestations of the World Health Organization's List of Pandemic and Epidemic Diseases

2021 ◽  
Vol 12 ◽  
Author(s):  
Caleb R. S. McEntire ◽  
Kun-Wei Song ◽  
Robert P. McInnis ◽  
John Y. Rhee ◽  
Michael Young ◽  
...  
Keyword(s):  
Virus Infection ◽  
Virus Disease ◽  
Case Reports ◽  
Hemorrhagic Fever ◽  
Hendra Virus ◽  
Marburg Virus ◽  
World Health ◽  
Neurological Manifestations ◽  
Valley Fever ◽  
The World

The World Health Organization (WHO) monitors the spread of diseases globally and maintains a list of diseases with epidemic or pandemic potential. Currently listed diseases include Chikungunya, cholera, Crimean-Congo hemorrhagic fever, Ebola virus disease, Hendra virus infection, influenza, Lassa fever, Marburg virus disease, Neisseria meningitis, MERS-CoV, monkeypox, Nipah virus infection, novel coronavirus (COVID-19), plague, Rift Valley fever, SARS, smallpox, tularemia, yellow fever, and Zika virus disease. The associated pathogens are increasingly important on the global stage. The majority of these diseases have neurological manifestations. Those with less frequent neurological manifestations may also have important consequences. This is highlighted now in particular through the ongoing COVID-19 pandemic and reinforces that pathogens with the potential to spread rapidly and widely, in spite of concerted global efforts, may affect the nervous system. We searched the scientific literature, dating from 1934 to August 2020, to compile data on the cause, epidemiology, clinical presentation, neuroimaging features, and treatment of each of the diseases of epidemic or pandemic potential as viewed through a neurologist's lens. We included articles with an abstract or full text in English in this topical and scoping review. Diseases with epidemic and pandemic potential can be spread directly from human to human, animal to human, via mosquitoes or other insects, or via environmental contamination. Manifestations include central neurologic conditions (meningitis, encephalitis, intraparenchymal hemorrhage, seizures), peripheral and cranial nerve syndromes (sensory neuropathy, sensorineural hearing loss, ophthalmoplegia), post-infectious syndromes (acute inflammatory polyneuropathy), and congenital syndromes (fetal microcephaly), among others. Some diseases have not been well-characterized from a neurological standpoint, but all have at least scattered case reports of neurological features. Some of the diseases have curative treatments available while in other cases, supportive care remains the only management option. Regardless of the pathogen, prompt, and aggressive measures to control the spread of these agents are the most important factors in lowering the overall morbidity and mortality they can cause.

scholarly journals Was it a case of acute disseminated encephalomyelitis? A rare association following dengue fever

2013 ◽  
Vol 04 (03) ◽  
pp. 318-321 ◽  
Author(s):  
Ritu Karoli ◽  
Zeba Siddiqi ◽  
Jalees Fatima ◽  
Sumit Maini
Keyword(s):  
Dengue Fever ◽  
Dengue Infection ◽  
Febrile Illness ◽  
Complete Recovery ◽  
Acute Disseminated Encephalomyelitis ◽  
Neurological Complications ◽  
Methyl Prednisolone ◽  
Immune Mediated ◽  
Atypical Manifestations ◽  
Lag Period

ABSTRACTDengue infection, caused by a flavivirus is endemic in more than hundred countries, mostly in the developing world. Recent observations indicate that the clinical profile of dengue is changing, and that atypical manifestations are being reported more frequently. The exact incidence of various neurological complications is variable. Acute disseminated encephalomyelitis (ADEM) is a neurological manifestation rarely described in association with dengue. We present a patient, 32-year-old female who was diagnosed as a case of dengue fever initially after an acute febrile illness and two weeks later admitted in emergency with seizures and altered sensorium. Although MRI did not show typical lesions suggestive of ADEM, the lag period between initial dengue infection and neurological manifestations and complete recovery with methyl prednisolone point towards immune mediated demyelinating illness.

scholarly journals Neurological complications in dengue infection: a review for clinical practice

2013 ◽  
Vol 71 (9B) ◽  
pp. 667-671 ◽  
Author(s):  
Marzia Puccioni-Sohler ◽  
Carolina Rosadas ◽  
Mauro Jorge Cabral-Castro
Keyword(s):  
Clinical Practice ◽  
Wide Spectrum ◽  
Dengue Infection ◽  
Clinical Signs ◽  
Public Health Problem ◽  
Hemorrhagic Fever ◽  
Neurological Complications ◽  
World Health ◽  
World Population ◽  
Global Public Health

Dengue is an important global public health problem. The World Health Organization estimates that 2/5 of entire world population are in risk of dengue infection. Almost 50 millions cases occur annually, with at least 20 thousand deaths. The etiological agent of this acute febrile disease is a single-strand positive-sense RNA virus of Flavivirus genus. It is an arboviral disease transmitted by Aedes sp. mosquitoes (Aedes aegypti and A. albopictus). Most infected individuals present asymptomatic infection, but some may develop clinical signs. Therefore, a wide spectrum of illness can be observed, ranging from unapparent, mild disease, called dengue fever, to a severe and occasionally fatal dengue hemorrhagic fever/dengue shock syndrome. Currently, neurological manifestations related to dengue infections are increasingly been observed and appears as a challenge for medical practice. In this study the neurological complications of dengue infection will be reviewed, focusing a better understanding of the disease for the clinical practice.

scholarly journals Dengue infection in the nervous system: lessons learned for Zika and Chikungunya

2017 ◽  
Vol 75 (2) ◽  
pp. 123-126 ◽  
Author(s):  
Marzia Puccioni-Sohler ◽  
Natalia Roveroni ◽  
Carolina Rosadas ◽  
Fernando Ferry ◽  
Jose Mauro Peralta ◽  
...  
Keyword(s):  
Nervous System ◽  
Congenital Malformations ◽  
Laboratory Tests ◽  
Dengue Infection ◽  
Neurological Complications ◽  
Lessons Learned ◽  
The World ◽  
Tropical Areas ◽  
Geographic Expansion ◽  
The Impact

ABSTRACT Dengue, Zika and Chikungunya are emerging arboviruses and important causes of acute febrile disease in tropical areas. Although dengue does not represent a new condition, a geographic expansion over time has occurred with the appearance of severe neurological complications. Neglect has allowed the propagation of the vector (Aedes spp), which is also responsible for the transmission of other infections such as Zika and Chikungunya throughout the world. The increased number of infected individuals has contributed to the rise of neurological manifestations including encephalitis, myelitis, meningitis, Guillain-Barré syndrome and congenital malformations such as microcephaly. In this narrative review, we characterize the impact of the geographic expansion of the vector on the appearance of neurological complications, and highlight the lack of highly accurate laboratory tests for nervous system infections. This represents a challenge for public health in the world, considering the high number of travelers and people living in endemic areas.

scholarly journals Immunoglobulin M and G in Virologically Confirmed Dengue Hemorrhagic Fever

2019 ◽  
Vol 32 (3-4) ◽  
pp. 65-74
Author(s):  
Tatang K. Samsi ◽  
H. Wulur ◽  
D. Sugianto ◽  
C. R. Bartz ◽  
R. Tan ◽  
...  
Keyword(s):  
Dengue Hemorrhagic Fever ◽  
Virus Isolation ◽  
Dengue Infection ◽  
Preliminary Finding ◽  
Hemorrhagic Fever ◽  
Immunoglobulin M ◽  
Sudden Increase ◽  
Serum Samples ◽  
Capture Elisa ◽  
One Year

Starting from September 1987, a one year prospective study on lgM and lgG in dengue hemorrhagic fever, was carried out at the Department of Pediatrics, Sumber War as Hospital West Jakarta. This report describes the preliminary finding of the study from September 1987 through June 1988. Virus isolation and serologic analysis (HI, lgG and lgM capture ELISA) for DHF were done by NAMRU 2 in Jakarta. The subjects were 151 virologically confirmed DHF patients consisting of 82 boys and 69 girls of 6 months - 15 years old. Serum samples were collected: (I) on the day of admission; (II) on the day of discharge and (Ill) 2 weeks after the first samples. Serum samples I, II, and Ill were collected from respectively 151, 131 and 64 subjects on respectively 3.5 ± 1.7; 8.8 ± 2.7 and 16.8 ± 2.1 days of illness. Positive lgM titer from acute sera was observed in 20% of subjects. A positive correlation between HI -lgM and HI -lgG was also observed. The percentage of positive lgM titers rose with the increase of HI titer, the percentage of positive lgG titer was lower than that of /gM but a sudden increase exceeding that of lgM was observed at the HI liter of 320 and more. This study revealed that HI titer of640 and 1280 were indicators for the primary and secondary dengue infection respectively and lgM capture ELISA can be used as a reliable predictor for DHF even more in fatal cases where only single serum is available.

scholarly journals Neurological manifestations of coronavirus infections: a systematic review

2020 ◽  
Author(s):  
Jesper Almqvist ◽  
Tobias Granberg ◽  
Antonios Tzortzakakis ◽  
Stefanos Klironomos ◽  
Evangelia Kollia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cerebrovascular Disorders ◽  
Acute Disseminated Encephalomyelitis ◽  
Neurological Complications ◽  
Diagnostic Workup ◽  
Neurological Manifestations ◽  
Chronic Disability ◽  
Neuropsychiatric Complications ◽  
Immune Mediated ◽  
Depth Analysis

In order to optimize diagnostic workup of the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, we systematically reviewed neurological and neuroradiological manifestations of SARS-CoV-2 and all other known human coronavirus species (HCoV). Which lessons can we learn? We identified relevant publications (until July 26h 2020) using systematic searches in PubMed, Web of Science and Ovid EMBASE with predefined search strings. A total of 4571 unique publications were retrieved, out of which 378 publications were selected for in-depth analysis by two raters, including a total of 17549 (out of which were 14418 SARS-CoV-2) patients. Neurological complications and associated neuroradiological manifestations are prevalent for all HCoVs (HCoV-229E, HKU1, NL63, OC43, Middle East respiratory syndrome (MERS)-CoV, SARS-CoV-1 and SARS-CoV-2). Moreover, there are similarities in symptomatology across different HCoVs, particularly between SARS-CoV-1 and SARS-CoV-2. Common neurological manifestations include fatigue, headache and smell/taste disorders. Additionally, clinicians need to be attentive for at least five classes of neurological complications: (1) Cerebrovascular disorders including ischemic stroke and macro/micro-hemorrhages, (2) encephalopathies, (3) para-/postinfectious immune-mediated complications such as Guillain-Barre syndrome and acute disseminated encephalomyelitis, (4) (meningo-)encephalitis, potentially with concomitant seizures and (5) neuropsychiatric complications such as psychosis and mood disorders. Our systematic review highlights the need for vigilance regarding neurological complications in patients infected by SARS-CoV-2 and other HCoVs, especially since some complications may result in chronic disability. Neuroimaging protocols should be designed to specifically screen for these complications. Therefore, we propose practical imaging guidelines to facilitate the diagnostic workup and monitoring of patients infected with HCoVs.

scholarly journals SGOT and SGPT Levels in Patients with Dengue Hemorrhagic Fever

2019 ◽  
Vol 1 (2) ◽  
pp. 98-101
Author(s):  
Cahyaningrum Trisnowati
Keyword(s):  
Dengue Hemorrhagic Fever ◽  
Liver Dysfunction ◽  
Normal Values ◽  
Dengue Infection ◽  
Hemorrhagic Fever ◽  
Normal Value ◽  
Consecutive Sampling ◽  
Normal Limits ◽  
The World ◽  
Severity Of The Disease

Dengue hemorrhagic fever (DHF) is still one of the health problems in the world because its prevalence tends to increase and its spread is wider. Liver dysfunction is a result of dengue infection which often appears in the form of hepatomegaly and mild-to-moderate elevations in the enzyme aminotransferase (SGOT SGPT). Aminotransferase enzymes tend to be higher along with the severity of the disease. The purpose of this study was to determine the levels of SGOT and SGPT in patients with DHF who were treated at Harapan Magelang Hospital in January 2020 until March 2020. This research is descriptive. The number of samples in this study were 83 patients who were treated at Harapan Magelang Hospital. Sampling was done by consecutive sampling. The results of the study resulted in an increase in SGOT by 84.7% and an increase in SGPT by 51.8%. Most of the increase in SGOT is mild-moderate, increasing 1-3 x from the normal value of 53% n = 44/83 and increasing 3-10x from the normal value of 26.5% n = 22/83 while the SGPT is mostly still within normal limits 48.5% n = 40/83. The average SGOT level obtained was 129.5 U / l and the average SGPT level was 87.7 U / L. The conclusion was that SGOT levels increased more mildly 1-3 x than normal values and SGPT levels were still within normal limits in patients with dengue fever.

Overview of COVID-19 and neurological complications

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Nasrin Hosseini ◽  
Shabnam Nadjafi ◽  
Behnaz Ashtary
Keyword(s):  
Nervous System ◽  
Severe Acute Respiratory Syndrome ◽  
Cranial Nerve ◽  
Virus Disease ◽  
Neurological Complications ◽  
The Body ◽  
Neurological Manifestations ◽  
Wide Range ◽  
The World ◽  
Symptoms And Signs

Abstract The sudden and storming onset of coronavirus 2 infection (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) was associated by severe acute respiratory syndrome. Recently, corona virus disease 19 (COVID-19) has appeared as a pandemic throughout the world. The mutational nature of the virus, along with the different means of entering and spreading throughout the body has involved different organs. Thus, patients are faced with a wide range of symptoms and signs. Neurological symptoms, such as anosmia, agnosia, stroke, paralysis, cranial nerve deficits, encephalopathy, meningitis, delirium and seizures, are reported as common complications affecting the course of the disease and its treatment. In this review, special attention was paid to reports that addressed the acute or chronic neurological manifestations in COVID-19 patients who may present acute respiratory syndrome or not. Moreover, we discussed the central (CNS) and peripheral nervous system (PNS) complications in SARS-Cov2-infected patients, and also the pathophysiology of neurological abnormalities in COVID-19.

scholarly journals SARS-CoV-2 and the Nervous System: From Clinical Features to Molecular Mechanisms

2020 ◽  
Vol 21 (15) ◽  
pp. 5475 ◽  
Author(s):  
Manuela Pennisi ◽  
Giuseppe Lanza ◽  
Luca Falzone ◽  
Francesco Fisicaro ◽  
Raffaele Ferri ◽  
...  
Keyword(s):  
Nervous System ◽  
Molecular Mechanisms ◽  
Neuronal Damage ◽  
Neurological Complications ◽  
Neurological Manifestations ◽  
Wide Range ◽  
Inflammatory State ◽  
Acute Polyneuropathy ◽  
The Central Nervous System ◽  
The Impact

Increasing evidence suggests that Severe Acute Respiratory Syndrome-coronavirus-2 (SARS-CoV-2) can also invade the central nervous system (CNS). However, findings available on its neurological manifestations and their pathogenic mechanisms have not yet been systematically addressed. A literature search on neurological complications reported in patients with COVID-19 until June 2020 produced a total of 23 studies. Overall, these papers report that patients may exhibit a wide range of neurological manifestations, including encephalopathy, encephalitis, seizures, cerebrovascular events, acute polyneuropathy, headache, hypogeusia, and hyposmia, as well as some non-specific symptoms. Whether these features can be an indirect and unspecific consequence of the pulmonary disease or a generalized inflammatory state on the CNS remains to be determined; also, they may rather reflect direct SARS-CoV-2-related neuronal damage. Hematogenous versus transsynaptic propagation, the role of the angiotensin II converting enzyme receptor-2, the spread across the blood-brain barrier, the impact of the hyperimmune response (the so-called “cytokine storm”), and the possibility of virus persistence within some CNS resident cells are still debated. The different levels and severity of neurotropism and neurovirulence in patients with COVID-19 might be explained by a combination of viral and host factors and by their interaction.

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