Abstract Details

Title NEUROLOGIC MANIFESTATIONS OF ARBOVIRUSES IN THE EPIDEMY OF PERNAMBUCO, BRAZIL

Topic Neuroepidemiology

Presentation(s) (-)

Poster/Presentation
Number 004

Background The arbovirus of the Flaviviridae family, Flavivirus genus, and Togaviridae family, are group IV RNA viruses, such as dengue, zika and chikungunya. They are a public health problem in Brazil, due to increased proliferation of vetor⁴, and in Pernambuco, because they have shown unusual neurological manifestations. The literature on neurological disorders related to arboviruses reports myelitis, encephalitis, meningoencephalitis, encephalopathy, Guillain Barre syndrome, and optic neuritis, among other with low frequency.

Objective

Design/Methods We present a cohort with follow up from December 2014 to June 2015, including six patients attempted at Emergence Room and Neurology Outpatient Department at Hospital da Restauração, Pernambuco, Brazil. Their clinical complaints, compatible with arboviroses, evolved to neurologic symptoms and signs attributable to autoimmune diseases. All patients were submitted to clinic and neurologic examination, laboratory tests, as well as to PCR-RT viral genome detection method, and some of them were submitted to MRI.

Results The symptoms presentation was fever followed by cutaneous rash. Some patients had also pruritus, myalgia, arthralgia and conjunctival hyperemia. Neurologic manifestations appeared from zero to 15 days after first clinical symptoms. There was MRI white matter lesions in two acute disseminated encephalomyelitis cases and elevated protein concentration with normal cell count of four Guillain-Barré Syndrome cases. Blood and CFS molecular test for arboviroses were positive only to Zika virus. After hospital discharge, five patients maintained motor dysfunction, one patient had low visual acuity and another presented cognitive decline.

Conclusions There are strong evidences that the epidemic feature has different neurological manifestations than those referred in the literature.

Authors/Disclosures
Maria Lucia Brito Ferreira, MD	No disclosure on file

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