NEUROLOGICAL MANIFESTATIONS OF RABIES

Abstract

BACKGROUND- Rabies is a fatal disease transmitted through bites of animals harboring the virus in their saliva. Rabies continues to be a scourge in developing countries. SUMMARY- The virus is initially transported from the site of inoculation to the central nervous system and is subsequently transported back to peripheral neural and extraneural sites via the axoplasm of the peripheral nerves. Encephalitic rabies is characterized by prominent limbic dysfunction. Paralytic rabies manifests as ascending paralysis resulting in quadriparesis. It can occur independently, or encephalitis may supervene terminally. Antemortem diagnosis is dependent on demonstration of the rabies antigen by fluorescent antibody technique in nuchal skin biopsies and corneal impression smears. The postmortem diagnosis of rabies is confirmed by demonstration of Negri bodies on histopathological examination of the brain. Treatment includes prophylactic administration of vaccine and rabies immunoglobulin. There is no known cure for the disease. CONCLUSIONS- Rabies often poses a diagnostic challenge to unsuspecting clinicians because of its varied and deceptive clinical manifestations. Early confirmation of the diagnosis is mandatory for obvious reasons. Education of the public and health workers is mandatory to decrease the ravages of this disease.