Acute disseminated encephalomyelitis complicating dengue infection with neuroimaging mimicking multiple sclerosis: A report of two cases

Viswanathan, Sameer; Botross, Nevein Philip; Rusli, B N; Riad, Amgad

doi:10.1016/j.msard.2016.10.001

Cited by 14 publications

(15 citation statements)

References 4 publications

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“…ADEM is characterized by an acute inflammatory demyelinating ailment affecting the CNS, a monophasic course, and multifocal white matter involvement which occurs during or after dengue virus infection (Puccioni-Sohler et al, 2013 ). PubMed and Scopus combinely reported only 7 cases prior to May 2017 (Yamamoto et al, 2002 ; Brito et al, 2007 ; Gera and George, 2010 ; Sundaram et al, 2010 ; Gupta et al, 2013 ; Viswanathan et al, 2016 ). ADEM onset occurs within a limited time (averaging 5.6 days) after initial dengue signs (Gupta et al, 2013 ).…”

Section: Central Neurological System Complicationsmentioning

confidence: 99%

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Neurological Manifestations of Dengue Infection

Zhang

Liu

et al. 2017

Front. Cell. Infect. Microbiol.

154

146

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Dengue counts among the most commonly encountered arboviral diseases, representing the fastest spreading tropical illness in the world. It is prevalent in 128 countries, and each year >2.5 billion people are at risk of dengue virus infection worldwide. Neurological signs of dengue infection are increasingly reported. In this review, the main neurological complications of dengue virus infection, such as central nervous system (CNS), peripheral nervous system, and ophthalmic complications were discussed according to clinical features, treatment and possible pathogenesis. In addition, neurological complications in children were assessed due to their atypical clinical features. Finally, dengue infection and Japanese encephalitis were compared for pathogenesis and main clinical manifestations.

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Section: Central Neurological System Complicationsmentioning

confidence: 99%

“…ADEM onset occurs within a limited time (averaging 5.6 days) after initial dengue signs (Gupta et al, 2013 ). An abnormal CSF contributes to ADEM diagnosis, while a normal CSF cannotrule out its possibility (Viswanathan et al, 2016 ).…”

Section: Central Neurological System Complicationsmentioning

confidence: 99%

Neurological Manifestations of Dengue Infection

Zhang

Liu

et al. 2017

Front. Cell. Infect. Microbiol.

154

146

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“…Another report described changes mimicking multiple sclerosis at MRI in their patients, positive for dengue. 59 We have seen, in our 5 16…”

Section: Encephalopathy Versus Encephalitismentioning

confidence: 80%

Neuroimaging in dengue:CTandMRIfeatures

Noh

Rashid

Zaidi

et al. 2018

Neurology & Clinical Neurosc

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Neurological manifestations of dengue are increasingly seen, especially in endemic regions. The wide availability of cross sectional imaging has allowed radiological depiction of CNS involvement in symptomatic patients. Classically, dengue was thought to be a nonneurotropic virus; however, increasing evidence is suggesting central nervous system involvement. A number of pathophysiologic mechanisms have been proposed to explain the development of the neurological symptoms seen. Although there is no specific neuroimaging feature at present, knowledge of its variable appearance may aid in treatment, prognostication, and follow up. In this article, we attempt to review, comprehensively, the spectrum of neuroimaging findings in dengue, via CT and MRI. We also discuss some common pitfalls associated with this disease entity.

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“…In such cases, T2-weighted magnetic resonance imaging reveals signal abnormalities in the subcortical and periventricular white matter, with or without gray matter involvement. Dengue-associated acute disseminated encephalomyelitis, being an immune mediated disorder of the central nervous system, has been shown to respond well to intravenous methylprednisolone [2]. …”

Section: Discussionmentioning

confidence: 99%

“…Indirect mechanisms such as impaired kidney and liver dysfunctions, hypoxic-ischemic insults, and other metabolic disorders can affect brain function and clinically present as encephalopathy. In addition to direct viral involvement of brain, there are several other pathologies like ischemic and hemorrhagic strokes, subdural hematoma, cerebral venous thrombosis, and acute disseminated encephalomyelitis that can affect the brain [2–6] (Table 1). …”

Section: Introductionmentioning

confidence: 99%

Cortical laminar necrosis in dengue encephalitis—a case report

et al. 2017

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BackgroundDengue encephalitis is a rare neurological manifestation of dengue fever. Its clinical presentation is similar to other viral encephalitides and encephalopathy. No single specific finding on magnetic resonance imaging of dengue encephalitis has yet been documented. They are highly variable and atypical.Case presentationA 15-year boy presented with fever, the headache and altered sensorium of 12-day duration. On neurological examination, his Glasgow Coma Scale score was 10 (E3M4V3). There was no focal neurological deficit. Laboratory evaluation revealed leukopenia and marked thrombocytopenia. Dengue virus IgM antibody was positive both in serum and cerebrospinal fluid. Magnetic resonance imaging of the brain revealed signal changes in bilateral parietooccipital and left frontal regions (left hemisphere more involved than the right hemisphere). There was gyriform enhancement bilateral parietooccipital regions consistent with cortical laminar necrosis. Bilaterally diffuse subcortical white matter was also involved and subtle T2 hyperintensity involving both basal ganglia was noted. Gradient echo sequence revealed presence of hemorrhage in the subcortical white matter. Patient was treated conservatively and received platelet transfusion. Patient became fully conscious after 7 days.ConclusionIn a patient with highly suggestive dengue e\ephalitis, we describe an unusual magnetic resonance imaging finding. This report is possibly the first instance of cortical laminar necrosis in such a setting.

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Acute disseminated encephalomyelitis complicating dengue infection with neuroimaging mimicking multiple sclerosis: A report of two cases

Cited by 14 publications

References 4 publications

Neurological Manifestations of Dengue Infection

Neurological Manifestations of Dengue Infection

Neuroimaging in dengue:CTandMRIfeatures

Cortical laminar necrosis in dengue encephalitis—a case report

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