Neurological manifestations in dengue

Abstract

Abstract Dengue, an acute febrile illness caused by Flavivirus, is among the most frequent arbovirus in tropical regions. Mostly infections are asymptomatic, but disease manifestations may range from minimal symptoms to death. For the first time in 2009, WHO has given importance to neurological manifestations and considered this as criteria for severe dengue infection. Neurological complications are being seen more frequently nowadays which were not seen during previous dengue virus outbreaks. Increasingly, lot of unusual case reports, case series, and studies on neurological manifestations have been published in the existing literature. The present review focuses on the recent insights on the neurological manifestations and the pathogenesis of neural involvement of dengue virus. Neurological complications of dengue virus infection can be categorised into dengue encephalopathy, encephalitis, immune-mediated syndromes, muscle dysfunction, and neuro-ophthalmic disorders. The neurological manifestations in dengue infection are primarily caused by DENV-2 and DENV-3. The neurological involvement in dengue can be due to possible four mechanisms: (a) metabolic imbalance; (b) haemorrhagic disturbance; (c) post-infectious autoimmune reaction; (d) direct infection by virus. There is no specific treatment for dengue, but supportive and symptomatic management is essential with emphasis on prompt fluid resuscitation, along with early recognition of dengue and its complications.