Karoli Ritu, Siddiqi Zeba, Fatima Jalees, Maini Sumit
Department of Medicine, Era's Lucknow Medical College, Sarfarazganj, Lucknow, Uttar Pradesh, India.
J Neurosci Rural Pract. 2013 Jul;4(3):318-21. doi: 10.4103/0976-3147.118783.
Dengue infection, caused by a flavivirus is endemic in more than hundred countries, mostly in the developing world. Recent observations indicate that the clinical profile of dengue is changing, and that atypical manifestations are being reported more frequently. The exact incidence of various neurological complications is variable. Acute disseminated encephalomyelitis (ADEM) is a neurological manifestation rarely described in association with dengue. We present a patient, 32-year-old female who was diagnosed as a case of dengue fever initially after an acute febrile illness and two weeks later admitted in emergency with seizures and altered sensorium. Although MRI did not show typical lesions suggestive of ADEM, the lag period between initial dengue infection and neurological manifestations and complete recovery with methyl prednisolone point towards immune mediated demyelinating illness.
由黄病毒引起的登革热感染在一百多个国家呈地方性流行，主要在发展中世界。最近的观察表明，登革热的临床特征正在发生变化，非典型表现的报告更为频繁。各种神经并发症的确切发病率各不相同。急性播散性脑脊髓炎（ADEM）是一种很少与登革热相关描述的神经表现。我们报告一名32岁女性患者，在急性发热性疾病后最初被诊断为登革热，两周后因癫痫发作和意识改变而急诊入院。尽管磁共振成像（MRI）未显示提示ADEM的典型病变，但初始登革热感染与神经表现之间的延迟期以及甲基强的松龙治疗后完全康复表明为免疫介导的脱髓鞘疾病。
