Autor(es): Tournebize P, Charlin C, Lagrange M

Resumo: We are reporting 23 cases of patients presenting neurological symptoms in the setting of a chikungunya outbreak that occurred in the Indian Ocean from March 2005 to April 2006. These symptoms were the cause of admission in our ward, mainly via the emergency room. In the acute phase of their illness, 23 patients presented neurological symptoms associated with positive CSF tests (specific IgM or RT- PCR). Clinical manifestations included disrupted behavior or altered mental status in 95% of patients, headache in 30.4%, seizure in 26%, motor dysfunction in 4.3% - sensorial disorders in 8.7%. Outcome was fatal in two patients during their hospitalisation - several months after discharge in three other elderly bedridden patients with altered general status. CSF analysis was sometimes but not always inflammatory. CT or MRI, when done, showed no recent abnormality. EEG disclosed most often of a diffuse moderately slowed activity with no pseudo-periodic or unusual pattern. A few epileptic aspects were seen in known epileptic patients. The outcome of the neurological symptoms was generally good over a few days, contrasting with persisting impairment of general status - severe joint pains leading to a bedridden state - death in three patients. Nervous system involvement was not uncommon during the chikungunya outbreak in Reunion Isl- in 2005 - 2006. The most frequent expression was moderate confusion occurring during the acute phase of infection. Peripheral nerve involvement in the form of a typical Guillain Barré syndrome was also observed. In general, the neurological outcome was very good. Fatal issues occurring in the early stages or later on (five out of 23 patients) were related to altered general condition in debilitated bedridden elderly patients.

Palavras-Chave: Encephalitis; Guillain Barré syndrome; Chikungunya virus

Imprenta: Revue Neurologique, v. 165, n. 1, p. 48-51, 2009

Identificador do objeto digital: 10.1016/j.neurol.2008.06.009

Descritores: Chikungunya virus - Cytopathology; Chikungunya virus - Pathogenesis; Chikungunya virus - Viral infections; Chikungunya virus - Clinical examination; Chikungunya virus - RT-PCR; Chikungunya Virus - Virus

Data de publicação: 2009

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