Neurological manifestations of Chikungunya

Manifestações neurológicas da Chikungunya

Dear Editor,

The report by Pinheiro et al. on “Dengue infection in the nervous system: lessons learned for Zika and Chikungunya (CHIK) Infection” is very interesting¹. The authors mentioned that “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 criteria¹”. They also discussed the clinical neurological problems due to Zika virus infection. Indeed, the similarity between clinical problems due to CHIKV and other arboviruses (dengue and Zika virus) can be observed. Nevertheless, a number of cases with those virus infections can be mild or asymptomatic.

Focusing on neurological problems due to CHIKV, we would like to share the experience from our setting, a tropical area, in Indochina. In our clinical centers, both dengue and CHIKV infections are common. Unlike dengue infection, the neurological problems of CHIKV are extremely rare, which is similar to the cases of Zika virus infection. According to a national report in Thailand on the confirmed cases of viral encephalitis during 2003–2005, there were no cases due to CHIKV infection². Also, according to the latest large outbreak in a rural province in Thailand, many classical and atypical presentations of CHIKV infection have been observed but there were no patients presenting with neurological problems³.

References

• ¹
  Pinheiro TJ, Guimarães LF, Silva MT, Soares CN. Neurological manifestations of Chikungunya and Zika infections. Arq Neuropsiquiatr. 2016;74(11):937-43. https://doi.org/10.1590/0004-282x20160138
  » https://doi.org/10.1590/0004-282x20160138
• ²
  Olsen SJ, Campbell AP, Supawat K, Liamsuwan S, Chotpitayasunondh T, Laptikulthum S et al. Infectious causes of encephalitis and meningoencephalitis in Thailand, 2003-2005. Emerg Infect Dis. 2015;21(2):280-9. https://doi.org/10.3201/eid2102.140291
  » https://doi.org/10.3201/eid2102.140291
• ³
  Wanlapakorn N, Thongmee T, Linsuwanon P, Chattakul P, Vongpunsawad S, Payungporn S et al. Chikungunya outbreak in Bueng Kan Province, Thailand, 2013. Emerg Infect Dis. 2014;20(8):1404-6. https://doi.org/10.3201/eid2008.140481
  » https://doi.org/10.3201/eid2008.140481

Publication Dates

• Publication in this collection
  May 2017

History

• Received
  06 Dec 2016
• Accepted
  09 Dec 2016