Abstract
BackgroundDengue fever is an endemic illness in the tropics with early and post infectious complications affecting multiple systems. Though neurological sequelae including mononeuropathy, encephalopathy, transverse myelitis, polyradiculopathy, Guillain-Barre syndrome , optic neuropathy and oculomotor neuropathy have been reported in medical literature, the abducens nerve despite its notoriety in cranial neuropathies in a multitude of condition due to its long intracranial course had not been to date reported to manifest with lateral rectus paralysis following dengue.Case presentationA previously well 29 year old male with serologically confirmed dengue hemorrhagic fever developed symptomatic right lateral rectus palsy during the critical phase of the illness, which persisted into convalescence and post convalescence with proven deficit on Hess screen. Alternate etiologies were excluded by imaging, serology and electrophysiology.ConclusionsThe authors detail the first reported case of abducens nerve palsy complicating dengue fever in a previously healthy male from Sri Lanka. In a tropical country with endemic dengue infections, dengue related abducens neuropathy may be considered as a differential diagnosis in cases of acquired lateral rectus palsy after dengue fever.
Highlights
Dengue fever is an endemic illness in the tropics with early and post infectious complications affecting multiple systems
In a tropical country with endemic dengue infections, dengue related abducens neuropathy may be considered as a differential diagnosis in cases of acquired lateral rectus palsy after dengue fever
Encephalopathy, transverse myelitis, polyradiculopathy, Guillain-Barre syndrome, oculomotor neuropathy and optic neuropathy [2,3,4,5,6,7] have all been documented in literature to date, abducens nerve palsy has eluded clinical observation
Summary
This is the first reported isolated case of abducens neuropathy in a patient who had dengue infection. This case illustrates that post-dengue infected patients may develop abducens neuropathy as an isolated neurological complication. In a tropical country with endemic dengue infections, post dengue infection abducens neuropathy may be considered as a differential diagnosis in cases of acquired convergent squint with diplopia in compatible clinical scenarios. Consent Written informed consent was obtained from the patient for publication of this case report and any accompanying images. Authors’ contributions MCS was instrumental in evaluating the patient and drafting of this manuscript. ECR, CKS and KGKLG were instrumental in literature review and follow up of the patient. All authors read and approved the final manuscript
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