Neurologic Complications of Zika Virus in Adults

Summary and Comment |
August 25, 2017

Neurologic Complications of Zika Virus in Adults

  1. Jaime Toro, MD

Nearly 90% of patients with new-onset parainfectious or neuroinflammatory disease at a single hospital in Brazil had evidence of recent Zika virus infection.

  1. Jaime Toro, MD

Infection with Zika virus, an arbovirus transmitted by the Aedes species mosquito, has been associated with a number of neurologic manifestations, mainly microcephaly, Guillain-Barré syndrome (GBS), myelitis, and meningoencephalitis.

In a prospective observational cohort study at a referral hospital for neurologic diseases in Rio de Janeiro, Brazil, researchers evaluated the presence of Zika virus infection in 40 consecutive adult patients (15 women, 25 men) with new-onset parainfectious or neuroinflammatory disease. Of these patients, 29 (73%) had GBS, 7 (18%) encephalitis, 3 (8%) transverse myelitis, and 1 (3%) newly diagnosed chronic inflammatory demyelinating polyneuropathy. Overall, 88% of patients had evidence of recent Zika virus infection in serum, cerebrospinal fluid (CSF), or both, including 27 patients with GBS, 5 with encephalitis, 2 with transverse myelitis, and 1 with chronic inflammatory demyelinating polyneuropathy.

Comment

Zika virus was not initially thought to be an important cause of neurologic disease. Even though most Zika virus infections are asymptomatic, there are several associated neurologic manifestations, as seen in this study, that neurologists should be aware of. Though causality was not demonstrated here, the majority of patients studied were found to have evidence of recent Zika infection in the setting of a national rise in admissions for parainfectious and neuroinflammatory diseases following the Zika outbreak. Testing for Zika virus in serum and CSF should be done in patients with suspected Zika virus infection with neurologic manifestations and in areas with high prevalence of flavivirosis.

Editor Disclosures at Time of Publication

  • Disclosures for Jaime Toro, MD at time of publication Editorial boards Multiple Sclerosis and Related Disorders

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