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Neurological manifestations in dengue seropositive patients

      Objective: To study the incidence and spectrum of neurological manifestations in dengue seropositive patients.
      Background: Dengue is an infectious disease caused by a flavivirus. It is an acute febrile illness causing considerable morbidity and mortality. The neurological complications in dengue have been hypothesized to occur through three different pathogenic mechanisms: (1) direct neurotropic effects leading to encephalitis, meningitis, myelitis and myositis (2) indirect effects due to metabolic complications resulting in encephalopathy and cerebrovascular complications due to thrombocytopenia and platelet dysfunction and (3) postinfectious immune-mediated acute disseminated encephalomyelitis, Guillain Barré syndrome and optic neuritis.
      Material and methods: This was a descriptive cross sectional study including seropositive patients diagnosed with Dengue fever (DF), Dengue with warning signs and Severe Dengue with neurological manifestations presenting to Medicine Department of LLR Hospital, Kanpur.
      Results: 10 (2.6%) patients had neurological manifestations out of 383 seropositive patients. Out of ten, nine patients were male and only one patient was female. Among them 10% patients come under category of classical dengue fever, 10% patients suffered from dengue with warning signs and 80% with severe dengue .4 patients had encephalopathy,3 other patients had encephalitis, 2 patients presented with single episode of symptomatic generalized seizure and 1 patient presented as having an intra cranial hemorrhage.
      Conclusions: Neurological manifestations of dengue are manifold and it is necessary to consider dengue as a cause for the above neurological presentations in endemic zones of the disease.