Saeed Hasan, Rehman Gohar, Mehmood Qadri Haseeb, Sohail Amna, Ul Haq Arshaman, Sadiq Hafiz Zeeshan, Yasin Shahnila, Khalid Rana Muhammad Asadullah
Pathology, Shifa International Hospital, Islamabad, PAK.
Internal Medicine, Allama Iqbal Medical College, Lahore, PAK.
Cureus. 2025 Mar 21;17(3):e80960. doi: 10.7759/cureus.80960. eCollection 2025 Mar.
Zika virus (ZIKV) is a neurotropic virus closely linked to other flaviviruses like dengue virus, West Nile virus, yellow fever, and Japanese encephalitis virus. Though initially considered a mild virus, ZIKV gained everybody's attention when the World Health Organization (WHO) declared it a global public health emergency in February 2016. Being considered an important cause of innumerable neurological manifestations and pediatric modality, we aimed to present a comprehensive overview of the neurological details of ZIKV infection. This study reviews the neurological manifestations of ZIKV infection. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) strategy was employed, along with a combination of keywords, to enlist all articles with data on ZIKV and its neurological manifestations, diagnosis, and treatment. All case reports, case series, and systematic reviews published between 2017 and 2024, focusing on neurological manifestations of ZIKV, were included in this study. Case studies, editorials, letters to the editors, and clinical images were excluded. The search was conducted using Boolean operators "AND" and "OR" on PubMed and Google Scholar. A total of five case reports, one case series, and one systematic review and meta-analysis were included. Out of 603 patients, the study suggested a male preponderance of 366 patients (62.5%) for ZIKV infection. About 258 patients presented with rash (46.1%), 243 with fever (43.8%), and 134 with dysphagia (36.5%). Neurological signs on examination were limb paresis in 545 (91.1%) patients, areflexia in 401 (88.9%) patients, and tetraparesis in 153 (61%) patients. A significant finding on magnetic resonance imaging (MRI) showed enhancement of the distal cord, conus medullaris, and cauda equina in two cases (0.3%). Serological analysis showed a positive plaque reduction neutralization test (PRNT) in 125 (73.5%) patients. Increased protein levels were identified in 240 (78.7%) cases on cerebrospinal fluid (CSF) analysis. The commonest diagnostic modality utilized was polymerase chain reaction (PCR) in 118 (24.3%) cases. Intravenous immunoglobulins (IVIg) were used for the medical management of 442 patients included in this review (77.4%). ZIKV is known to cause insidious detrimental effects on the central nervous system regardless of the age of an individual. Being a cause of extreme sensorimotor disability, various preventive and precautionary measures are being undertaken to ensure early diagnosis and prevent prolonged liability on a patient's health. Effective therapeutics including IVIg have paved the way in bringing down the hurdles in the management and cure of the infection.
寨卡病毒（ZIKV）是一种嗜神经病毒，与登革病毒、西尼罗河病毒、黄热病病毒和日本脑炎病毒等其他黄病毒密切相关。尽管寨卡病毒最初被认为是一种温和的病毒，但当世界卫生组织（WHO）在2016年2月宣布其为全球突发公共卫生事件时，它引起了所有人的关注。由于被认为是无数神经症状和儿科病症的重要病因，我们旨在全面概述寨卡病毒感染的神经学细节。本研究回顾了寨卡病毒感染的神经学表现。采用系统评价和Meta分析的首选报告项目（PRISMA）策略，并结合关键词，列出所有包含寨卡病毒及其神经学表现、诊断和治疗数据的文章。本研究纳入了2017年至2024年间发表的所有聚焦于寨卡病毒神经学表现的病例报告、病例系列以及系统评价。病例研究、社论、给编辑的信以及临床图像被排除在外。使用布尔运算符“AND”和“OR”在PubMed和谷歌学术上进行检索。共纳入了5篇病例报告、1个病例系列以及1篇系统评价和Meta分析。在603名患者中，该研究表明寨卡病毒感染男性占优势，有366名患者（62.5%）。约258名患者出现皮疹（46.1%），243名患者发热（43.8%），134名患者吞咽困难（36.5%）。检查时的神经学体征为：545名患者（91.1%）肢体无力，401名患者（88.9%）无反射，153名患者（61%）四肢瘫。磁共振成像（MRI）的一项重要发现显示，2例（0.3%）患者脊髓远端、脊髓圆锥和马尾神经增强。血清学分析显示，125名患者（73.5%）的空斑减少中和试验（PRNT）呈阳性。脑脊液（CSF）分析发现240例（78.7%）患者蛋白质水平升高。最常用的诊断方法是聚合酶链反应（PCR），共118例（24.3%）。本综述纳入的442例患者（77.4%）采用静脉注射免疫球蛋白（IVIg）进行药物治疗。无论个体年龄如何，已知寨卡病毒都会对中枢神经系统造成潜在的有害影响。作为极端感觉运动障碍的一个病因，正在采取各种预防和防范措施以确保早期诊断并防止对患者健康造成长期损害。包括IVIg在内的有效治疗方法为降低感染管理和治疗中的障碍铺平了道路。
