- Dengue virus is a single-stranded RNA virus of the Flavivirus genus classified into four serotypes. Neurological manifestations, commonly seen with serotypes 2 and 3.
- Neurological manifestation in dengue hemorrhagic fever usually results from multisystem dysfunction secondary to liver failure, cerebral hypoperfusion, electrolyte imbalance, shock, cerebral edema, and hemorrhage related to vascular leak. Presentation as viral encephalitis is rare as the virus is non-neurotrophic.
- Patients can present with - stroke, mononeuropathies, polyneuropathies, Guillain-Barre syndrome (GBS), myelitis, meningitis, acute disseminated encephalomyelitis (ADEM), encephalopathy, encephalitis, neuromyelitis optica, and optic neuritis.
- Presence of dengue virus and anti-dengue IgM antibodies in patient's CSF with encephalitis suggests the possibility of direct cerebral invasion through infected macrophages.
- Clinical differentials can be differentiated by MRI -
- Japanese encephalitis – bilateral thalamic and basal ganglia involvement .
- Herpes encephalitis- bilateral temporal and basifrontal lobes lesions.
- Chikungunya encephalitis - white matter lesions with restricted diffusion without hemorrhage or basal ganglia involvement.
- Changes of ADEM in dengue fever are similar to Dengue encephalitis on MRI and may not be possible to differentiate on MRI always.
from Imaging via alkiviadis.1961 on Inoreader http://ift.tt/2jmcnts