Robin Stéphanie, Ramful Duksha, Le Seach' Florence, Jaffar-Bandjee Marie-Christine, Rigou Gérald, Alessandri Jean-Luc
Service de Pédiatrie, Centre Hospitalier Départemental Félix Guyon, La Réunion, France.
J Child Neurol. 2008 Sep;23(9):1028-35. doi: 10.1177/0883073808314151. Epub 2008 Feb 20.
Chikungunya virus, a mosquito-borne arbovirus, was responsible for a massive epidemic in La Réunion Island during 2005 to 2006. The disease is usually benign, but neurologic involvement, with sometimes fatal outcome, has been described. We report a retrospective hospital-based pediatric series of 30 children (23 boys and 7 girls) who presented neurologic manifestations of chikungunya such as encephalitis (n = 12), febrile seizures (n = 10), meningeal syndrome (n = 4), and acute encephalopathy (n = 4). Cerebrospinal fluid biological and cytological analyses (n = 23) were unremarkable except for 1 case of acute disseminated encephalomyelitis. The presence of viral genome in cerebrospinal fluid was inconstantly positive. Brain magnetic resonance imaging (MRI) scans (n = 14) were abnormal in 5 cases. Electroencephalography was nonspecific. Two patients died. At discharge and 6 months later, 5 children had neurologic sequelae. Patients with initial severe neurologic presentation and having pathological brain MRI had more sequelae or fatal disease.
基孔肯雅病毒是一种由蚊子传播的虫媒病毒，在2005年至2006年期间导致了留尼汪岛的大规模疫情。该疾病通常为良性，但也有神经受累的报道，有时会导致致命后果。我们报告了一项基于医院的回顾性儿科系列研究，该研究纳入了30名出现基孔肯雅神经表现的儿童（23名男孩和7名女孩），这些表现包括脑炎（n = 12）、热性惊厥（n = 10）、脑膜综合征（n = 4）和急性脑病（n = 4）。除1例急性播散性脑脊髓炎外，23例脑脊液生物学和细胞学分析无异常。脑脊液中病毒基因组的检测结果不一，有时呈阳性。14例脑部磁共振成像（MRI）扫描中有5例异常。脑电图检查无特异性。2例患者死亡。出院时及6个月后，5名儿童有神经后遗症。初始神经表现严重且脑部MRI异常的患者有更多后遗症或致命疾病。
