Neurologic manifestations of pediatric chikungunya infection

J Child Neurol. 2008 Sep;23(9):1028-35. doi: 10.1177/0883073808314151. Epub 2008 Feb 20.

Abstract

Chikungunya virus, a mosquito-borne arbovirus, was responsible for a massive epidemic in La Réunion Island during 2005 to 2006. The disease is usually benign, but neurologic involvement, with sometimes fatal outcome, has been described. We report a retrospective hospital-based pediatric series of 30 children (23 boys and 7 girls) who presented neurologic manifestations of chikungunya such as encephalitis (n = 12), febrile seizures (n = 10), meningeal syndrome (n = 4), and acute encephalopathy (n = 4). Cerebrospinal fluid biological and cytological analyses (n = 23) were unremarkable except for 1 case of acute disseminated encephalomyelitis. The presence of viral genome in cerebrospinal fluid was inconstantly positive. Brain magnetic resonance imaging (MRI) scans (n = 14) were abnormal in 5 cases. Electroencephalography was nonspecific. Two patients died. At discharge and 6 months later, 5 children had neurologic sequelae. Patients with initial severe neurologic presentation and having pathological brain MRI had more sequelae or fatal disease.

MeSH terms

  • Adolescent
  • Age Factors
  • Age of Onset
  • Brain / pathology
  • Brain / virology
  • Chikungunya virus / genetics
  • Chikungunya virus / isolation & purification*
  • Child
  • Child, Preschool
  • Consciousness Disorders / virology
  • Echoencephalography
  • Electroencephalography
  • Encephalitis, Arbovirus / diagnosis*
  • Encephalitis, Arbovirus / physiopathology*
  • Female
  • Headache / virology
  • Humans
  • Indian Ocean Islands
  • Infant
  • Infant, Newborn
  • Magnetic Resonance Imaging
  • Male
  • Meningitis, Viral / diagnosis*
  • Meningitis, Viral / physiopathology*
  • Meningitis, Viral / virology
  • RNA, Viral / genetics
  • RNA, Viral / isolation & purification
  • Retrospective Studies
  • Reverse Transcriptase Polymerase Chain Reaction

Substances

  • RNA, Viral