Objective: To determine the frequency and types of movement disorders in patients with dengue.

Background:

Dengue fever is a common viral infection presenting with fever, headache, and muscle pain. Movement disorders in the setting of dengue are rarely reported as case reports and limited information is available on its epidemiology.

Method: In this ambi-spective study, we collected series of patients presenting with movement disorders in the setting of dengue in our hospital. We collected data of all patients dengue from Jan 2015 to Dec 2022 . The patients with movement disorders were identified, their demographics, clinical presentation, laboratory and imaging findings were analyzed. The outcomes of the patients were noted at 3 months after discharge from the hospital or last follow-up visit.

Results: Of 736 patients with dengue,17 (2.31% ) had movement disorder. The manifestations were parkinsonism (7), ataxia(5), isolated opsoclonus(1), parkinsonism with dystonia(2), opsoclonus myoclonus ataxia (OMAS) (2). Movement disorders appeared after a duration of 5-15 days after onset of febrile illness. The patients with parkinsonism and dystonia had severe acute demyelinating encephalomyelitis with basal ganglia involvement following dengue shock syndrome, had prolonged course and needed steroids. All others had dengue fever followed by subacute onset of movement disorder, suggestive of a parainfectious autoimmune process. Patients with isolated ataxia or parkinsonism had a normal imaging or Reversible splenial lesion[ RESLES or CLOCCs].  7/17 patients had mild lymphocytic pleocytosis on CSF with raised protein and normal glucose, while others had normal CSF. Patients with ataxia or OMAS had spontaneous resolution in 2 weeks.Patients with parkisonism had symptomatic improvement with levodopa-carbidopa , which was stopped after 3 weeks. Most patients had good outcomes with complete resolution of symptoms in 4-6 weeks barring 2 patients with parkinsonism and dystonia who had persistent symptoms at 3 months

Conclusion:

Our study found that movement disorders can occur in patients with dengue fever, with a frequency of 2-3%. The types of movement disorders seen in these patients varied widely and included parkinsonism, isolated ataxia, isolated opsoclonus, OMAS, and parkinsonism with dystonia. However, the majority of patients had good outcomes, with complete resolution of symptoms within 4-6 weeks.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/movement-disorders-in-the-setting-of-dengue-infection-in-a-rural-medical-teaching-hospital-in-gujarat-india/