Batra Pranjali, Dhiman Neetu Rani, Hussain Ibrahim, Kumar Anand, Joshi Deepika
Department of Neurology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
Encephalitis. 2024 Oct;4(4):83-86. doi: 10.47936/encephalitis.2024.00066. Epub 2024 Oct 7.
Dengue is a mosquito-borne viral disease caused by the dengue virus (DENV). The clinical manifestations of DENV infection range from mild febrile illness to severe dengue shock syndrome and dengue hemorrhagic fever. Recently, its neurological manifestations have been reported. The mechanisms of neurological complications in DENV infection are often attributed to neurotropism or may be immune-mediated. A double-doughnut sign is a radiological pattern of signal changes in the bilateral thalami, resembling a doughnut. Although this sign has been reported with dengue encephalitis, Japanese encephalitis, and other neurotropic infections, its co-occurrence with mixed movement disorders is rare. We report a case of dengue encephalitis involving a spectrum of movement disorders in the form of jaw opening dystonia, stereotypies, parkinsonism, and tremors during recovery. Magnetic resonance imaging showed bilateral thalami involvement with a double-doughnut sign. The patient was managed with pulse steroid therapy and benzodiazepines and showed gradual improvement in symptoms. Movement disorders with DENV infection are rare and self-limiting.
登革热是一种由登革病毒（DENV）引起的蚊媒病毒性疾病。DENV感染的临床表现从轻度发热性疾病到严重登革热休克综合征和登革出血热不等。最近，其神经系统表现也有报道。DENV感染中神经并发症的机制通常归因于嗜神经性，也可能是免疫介导的。双环征是双侧丘脑信号改变的一种放射学模式，类似甜甜圈。尽管该征象已在登革热脑炎、日本脑炎及其他嗜神经性感染中被报道，但其与混合性运动障碍同时出现的情况罕见。我们报告1例登革热脑炎病例，在恢复过程中出现一系列运动障碍，表现为张口肌张力障碍、刻板动作、帕金森症和震颤。磁共振成像显示双侧丘脑受累并伴有双环征。该患者接受了脉冲类固醇治疗和苯二氮䓬类药物治疗，症状逐渐改善。DENV感染相关的运动障碍罕见且为自限性。
