Isolated Bell's palsy – An unusual presentation of dengue infection

Peter, Soumia; Malhotra, Nitin; Peter, P; Sood, Rahul

doi:10.1016/s1995-7645(12)60207-7

Cited by 24 publications

(25 citation statements)

References 12 publications

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“…Neurological involvement in dengue may occur because of neurotropism of the virus, immunological mechanisms, cerebral anoxia, intracranial hemorrhage, hyponatremia, cerebral edema, hepatic failure, renal failure, or release of toxic products. Peter et al [16] reported isolated facial nerve palsy in dengue fever and Shivanthan et al [17] have also reported isolated 6th nerve palsy. Donnio et al [18] reported dengue with a rare presentation of oculomotor nerve palsy.…”

Section: Discussionmentioning

confidence: 99%

Clinical Profiles of Dengue Infection during an Outbreak in Northern India

Laul

Merugumala

et al. 2016

Journal of Tropical Medicine

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Introduction. Dengue fever is an arboviral disease, which is transmitted by mosquito vector and presents as varied clinical spectrum of dengue fever (DF), dengue hemorrhagic fever (DHF), dengue shock syndrome (DSS), and expanded dengue syndrome (EDS) with atypical presentations, thus posing a diagnostic dilemma. Unless we are aware of these presentations, diagnosis as well as early initiation of treatment becomes difficult. We studied the various clinical presentations of dengue infection during an outbreak of disease in 2015. Materials and Methods. A total of 115 confirmed cases of dengue infection from Department of Medicine of Deen Dayal Upadhyay Hospital, New Delhi, were enrolled in this observational study. Results. The common signs and symptoms of dengue infection were fever, headache, body ache, backache, retro-orbital pain, bleeding manifestations, and rash in 100%, 87%, 86%, 58%, 41%, 21%, and 21%, respectively. Nonspecific or warning signs and symptoms included vomiting, weakness, abdominal pain, breathlessness, vertigo, sweating, and syncope. Other possible signs and symptoms of coinfections, comorbidities, or complications included diarrhea, sore throat, and neurological manifestations. There were seven patients with coinfections and four with comorbidities. The final diagnosis of these patients was DF (73%), DHF (16.5%), DSS (1.7%), and EDS (4.3%). Among EDS patients, the atypical presentations included encephalopathy, lateral rectus nerve palsy, acalculous cholecystitis, and myocarditis. Four patients required ICU care and there was no death in this study. Conclusion. Knowledge of atypical presentations is a must for early diagnosis and timely intervention to prevent life-threatening complications.

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Section: Discussionmentioning

confidence: 99%

Clinical Profiles of Dengue Infection during an Outbreak in Northern India

Laul

Merugumala

et al. 2016

Journal of Tropical Medicine

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“…Headache, alteration of consciousness, irritability, insomnia, seizures and focal neurological deficit associated with encephalitis, encephalopathy and stro ke pictures are the most common symptoms observed during the acute dengue. Other neurological manifestations, such as motor deficit can occur in acute dengue infection in cases of myelitis and myositis, or during post-dengue stage, in patients with polyradiculoneuritis, encephalomyelitis, neuromyelitis optica, polyneuropathy and mononeuropathy 8 .…”

Section: Dengue and The Nervous Systemmentioning

confidence: 99%

Neurological complications in dengue infection: a review for clinical practice

Puccioni-Sohler

Rosadas

Cabral‐Castro

2013

Arq. Neuro-Psiquiatr.

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The dengue virus belongs to the Flaviviridae family. There are four closely related, but antigenically different virus serotypes: DENV1 to DENV4. An infection caused by one of them can cause dengue fever and, rarely, most severe form of the disease. The infection provides life-long protective immunity to the same subtype, but no immunity against the other three serotypes. Moreover, previous infection with a different subtype increases the chances of developing dengue hemorrhagic fever. This is due to a phenomenon called antibody dependent enhancement (ADE). In ADE, the heterotypic non-neutralizing antibodies form complexes with dengue virus, which infect mononuclear phagocytes with enhanced efficiency. Consequently, a higher number of host cells are infected, improving viral replication, worsening the clinical signs. Thus, this may also contribute to the development of neurological and other complications 1 . The neurological manifestations are mainly associated with DENV-2 and DENV-3. These serotypes were found in cases of encephalitis, meningitis and myelitis 2,3 . DENV-4 was also detected in brain cells by immunohistochemistry and in cerebrospinal fluid (CSF) of a patient with encephalitis 4 . The present article highlights some important points that should be addressed when evaluating a possible case of neurological complication of dengue virus infection. Conflict of interest:There is no conflict of interest. ABStrACtDengue 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.Keywords: dengue, nervous system, diagnosis. rESUMO A dengue é um importante problema de saúde pública. A Organização Mundial de Saúde estima que 2/5 da população mundial encontra-se em risco de desenvolver a infecção. Cerca de 50 milhões de casos ocorrem anualmente, com ao menos 20 mil mortes. O agente etiológico desta doença febril aguda é um vírus RNA, do gênero Flavivirus. Este arbovírus é transmitido pelo mosquito Aedes sp. A maioria dos indivíduos infectados apresenta infecção assintomática, porém alguns desenvolvem sintomas clínicos. Estes manifestações podem...

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“…Bell's palsy results in weakness of facial muscles. 8 Bell's palsy, i.e. lower motor neuron seventh nerve palsy has been reported following dengue infection.…”

Section: Discussionmentioning

confidence: 99%

“…lower motor neuron seventh nerve palsy has been reported following dengue infection. 8 , Campylobacter enteritis. 9 , Rickettsial infection.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Facial Palsy: Post Vivax Malaria Scenario

Sawardekar¹,

Patil²,

Badgujar³

et al. 2016

jemds

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Malaria can cause severe complications, sometimes affecting central nervous system. Cranial nerve palsies are rare after malaria. Plasmodium vivax malaria, often thought to be a benign disease can sometime lead to severe complications. We report a case of lower motor neuron palsy after plasmodium vivax malaria. KEYWORDSFacial Palsy, Vivax Malaria. HOW TO CITE THIS ARTICLE: INTRODUCTIONMalaria is a common health problem in tropical countries like India. Of the four plasmodium species causing malaria in humans, P. vivax is the most widespread. P. vivax malaria in India is more prevalent than plasmodium falciparum. 1 In India P. vivax and P. falciparum accounts for about 60-65% and 35% cases respectively. 2 P. vivax is often thought to be benign infection; however, it may sometime result in severe complications affecting different organs. 3 Commonly reported severe complications of P. vivax malaria include haematological problems, such as anaemia and thrombocytopenia, liver or kidney dysfunction, lung related complications, hypoglycaemia, shock and cerebral malaria. 2,3 We report here an unusual case of bilateral lower motor neuron palsy after P. vivax malaria.

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Isolated Bell's palsy – An unusual presentation of dengue infection

Cited by 24 publications

References 12 publications

Clinical Profiles of Dengue Infection during an Outbreak in Northern India

Clinical Profiles of Dengue Infection during an Outbreak in Northern India

Neurological complications in dengue infection: a review for clinical practice

Bilateral Facial Palsy: Post Vivax Malaria Scenario

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