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Abstract Details

Long-term Outcome in Neurozika: When Biological Diagnosis Matters
Infectious Disease
S45 - Neuroinfectious Disease: Treatments, Diagnostics, and Outcomes (2:17 PM-2:28 PM)
008

Zika virus (ZIKV) postnatal infection has been associated with both central and peripheral neurological manifestations. The full spectrum, relative frequency and prognosis of these neurological manifestations have yet to be described.  

To characterize the full spectrum, relative frequency and prognosis of the neurological manifestations in Zika virus (ZIKV) postnatal infection.

We conducted an observational study in consecutive ZIKV-infected patients presenting with neurological manifestations during the French West Indies 2016 outbreak. 

Eighty-eight patients, including six children, were enrolled. Ninety-five percent of all cases required hospitalization. Guillain-Barré syndrome was the most frequent manifestation (46.6%) followed by encephalitis or encephalomyelitis (20.5%), isolated single or multiple cranial nerve palsies (9.1%), other peripheral manifestations (6.8%), and stroke (1.1%). Fourteen patients (15.9%) including one child, developed a mixed disorder involving both the central and peripheral nervous system. Mechanical ventilation was required in 21 cases all of whom had ZIKV RNA in at least one biological fluid. Two adult patients died due to neuroZika. Clinical follow-up (median 14 months; interquartile range, 12-17) was available for 77 patients. Residual disability (modified Rankin scale ≥2) was identified in 19 (24.7%) patients, in 6 cases (7.8%), disability was severe (modified Rankin scale ≥4). Amongst patients with ZIKV RNA detected in one biological fluid, the risk of residual disability or death was higher (odd ratio, 9.97; CI, 1.22 to 81.21; P=0.032). 

NeuroZika spectrum represents a heterogenous group of clinical neurological manifestations. During an outbreak, clinicians should consider neuroZika in patients presenting with cranial nerve palsies and a mixed neurological disorder. Long-term sequelae are frequent in NeuroZika. ZIKV reverse-transcription PCR status at admission can inform prognosis and should therefore be taken into consideration in the management of hospitalised patients.

Authors/Disclosures
Annie Lannuzel, MD (University Hospital)
PRESENTER
Dr. Lannuzel has nothing to disclose.
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Benoit Tressières No disclosure on file
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Eavan M. McGovern, MD No disclosure on file
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Emmanuel Roze, MD, PhD Dr. Roze has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for merz. Dr. Roze has received personal compensation in the range of $500-$4,999 for serving as a Consultant for orkyn. Dr. Roze has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for elivie. Dr. Roze has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for allergan. Dr. Roze has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Orkyn. Dr. Roze has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for elivie. Dr. Roze has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Aguettant. The institution of Dr. Roze has received research support from merz. The institution of Dr. Roze has received research support from Orkyn. Dr. Roze has received research support from elivie. The institution of Dr. Roze has received research support from allergan. The institution of Dr. Roze has received research support from fondation desmarest. The institution of Dr. Roze has received research support from everpharma. Dr. Roze has received research support from AMADYS. The institution of Dr. Roze has received research support from ADCY5.org. The institution of Dr. Roze has received research support from agence nationale de la recherche. The institution of Dr. Roze has received research support from société française de médecine esthétique. The institution of Dr. Roze has received research support from dystonia medical research foundation.