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Abstract
Objective: This study aimed to evaluate the incidence and clinical spectrum of neurologic complications, predictors of central and peripheral nervous system involvement, and their outcome in patients with dengue virus infection (DENV).
Methods: To determine the extent of neurologic complications, we used a hospital-based prospective cohort study design, which included laboratory-confirmed cases of dengue and follow-up for 3 months. We also analyzed clinical and laboratory data to assess predictors of neurologic involvement.
Results: The study included enrollment of 486 cases. Two were lost to follow-up and excluded. Forty-five patients developed neurologic complications. Of these, 28 patients had CNS and 17 had peripheral nervous system (PNS) involvement, representing an incidence rate for neurologic complications of 9.26%. Significant predictors of CNS involvement were higher mean body temperature (p = 0.012), elevated hematocrit (p = 0.009), low platelet count (p = 0.021), and liver dysfunction (p < 0.001). Predictors of PNS involvement were higher mean body temperature (p = 0.031), rash (p = 0.002), and elevated hematocrit (p < 0.001). The mortality rate was 4.5%. The remainder of the patients recovered.
Conclusion: An increasingly wide spectrum and higher incidence of neurologic complications of DENV are reported. Clinical and laboratory parameters such as higher mean body temperature, rash, increases in hematocrit, thrombocytopenia, and liver dysfunction are independent predictors of neurologic complications.
GLOSSARY
- ALT=
- alanine transaminase;
- AST=
- aspartate transaminase;
- CPK=
- creatine phosphokinase;
- DENV=
- dengue virus infection;
- DF=
- dengue fever;
- DHF=
- dengue hemorrhagic fever;
- GBS=
- Guillain-Barré syndrome;
- IgG=
- immunoglobulin G;
- IgM=
- immunoglobulin M;
- mRS=
- modified Rankin Scale;
- PNS=
- peripheral nervous system
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Editorial, page 1590
Supplemental data at Neurology.org
- Received January 19, 2014.
- Accepted in final form June 19, 2014.
- © 2014 American Academy of Neurology
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