Pinheiro Talys J, Guimarães Luis F, Silva Marcus Tulius T, Soares Cristiane N
Hospital dos Servidores do Estado, Serviço de Neurologia, Rio de Janeiro RJ, Brasil.
Laboratório de Pesquisa Clínica em Doenças Neuroinfecciosas, Instituto Nacional de Doenças Infecciosas Evandro Chagas/ Fundação Oswaldo Cruz, RJ, Brasil.
Arq Neuropsiquiatr. 2016 Nov;74(11):937-943. doi: 10.1590/0004-282X20160138.
The epidemics of Chikungunya virus (CHIKV) and Zika virus (ZIKV) infections have been considered the most important epidemiological occurrences in the Americas. The clinical picture of CHIKV infection is characterized by high fever, exanthema, myalgia, headaches, and arthralgia. Besides the typical clinical picture of CHIKV, atypical manifestations of neurological complications have been reported: meningo-encephalitis, meningoencephalo-myeloradiculitis, myeloradiculitis, myelitis, myeloneuropathy, Guillain-Barré syndrome and others. The diagnosis is based on clinical, epidemiological, and laboratory criteria. The most common symptoms of ZIKV infection are skin rash (mostly maculopapular), fever, arthralgia, myalgia, headache, and conjunctivitis. Some epidemics that have recently occurred in French Polynesia and Brazil, reported the most severe conditions, with involvement of the nervous system (Guillain-Barré syndrome, transverse myelitis, microcephaly and meningitis). The treatment for ZIKV and CHIKV infections are symptomatic and the management for neurological complications depends on the type of affliction. Intravenous immunoglobulin, plasmapheresis, and corticosteroid pulse therapy are options.
基孔肯雅病毒（CHIKV）和寨卡病毒（ZIKV）感染的流行被认为是美洲最重要的流行病学事件。CHIKV感染的临床表现以高热、皮疹、肌痛、头痛和关节痛为特征。除了CHIKV的典型临床表现外，还报告了神经并发症的非典型表现：脑膜脑炎、脑膜脑脊髓神经根炎、脊髓神经根炎、脊髓炎、脊髓神经病、吉兰-巴雷综合征等。诊断基于临床、流行病学和实验室标准。ZIKV感染最常见的症状是皮疹（大多为斑丘疹）、发热、关节痛、肌痛、头痛和结膜炎。最近在法属波利尼西亚和巴西发生的一些疫情报告了最严重的情况，涉及神经系统（吉兰-巴雷综合征、横贯性脊髓炎、小头畸形和脑膜炎）。ZIKV和CHIKV感染的治疗是对症治疗，神经并发症的处理取决于疾病类型。静脉注射免疫球蛋白、血浆置换和皮质类固醇脉冲疗法是可供选择的方法。
