• Dengue Virus Is an arbovirus which Transmitted by mosquitoes and Causes dengue and

dengue hemorrhagic fever.

• Its Composed of single-stranded RNA and Has 4 serotypes (DEN-1, 2, 3, 4). Each
serotype provides specific lifetime immunity, and short-term cross-immunity.All
serotypes can cause severe and fatal disease. Genetic variation within serotypes. Some
genetic variants within each serotype appear to be more virulent or have greater epidemic
potential

• Many neurological manifestations of dengue infection have been described to include

headache, seizure, depressed sensorium, behavioural disorders, neck stiffness, delirium,
paralysis, cranial nerve palsies and coma.

• Previously, reports of neurological manifestations in dengue infection had been referred

to as encephalopathy rather than encephalitis because attempts to demonstrate direct
invasion of the central nervous system (CNS) by dengue virus had failed. Animal studies
done in mice showed that the virus could break down the blood brain barrier leading to
CNS invasion.

• Various physiological events were thought to lead to encephalopathy such as cerebral

oedema, cerebral haemorrhage, hyponatraemia, fulminant hepatic failure, cerebral
anoxia, micro-capillary haemorrhage and release of toxic products. Virus-mediated
cytokines were responsible.CNS imaging studies in cases of dengue encephalitis have
shown that cerebral oedema is the predominant finding in the majority of patients
•
Figure 3 MRI brain of a 28-year-old man with dengue encephalitis(A) T2-weighted and
(B) fluid-attenuated inversion recovery axial image show bilateral basal ganglia
hyperintensities.
Neurologic complications in dengue virus infection

by Ritesh Sahu, Rajesh Verma, Amita Jain, Ravindra K. Garg, Maneesh K. Singh, Hardeep S.
Malhotra, Praveen K. Sharma, and Anit Parihar

Neurology

Volume 83(18):1601-1609