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Neurologic manifestations of pediatric chikungunya infection

Stéphanie Robin1, Duksha Ramful, Florence Le Seach'

  • 1Service de Pédiatrie, Centre Hospitalier Départemental Félix Guyon, La Réunion, France. st-robin@chd-fguyon.fr

Journal of Child Neurology
|February 22, 2008
PubMed

Insights

Chikungunya virus infection can cause severe neurological problems in children, including encephalitis and seizures. Some children experienced long-term neurological issues or died, especially those with severe initial symptoms or abnormal brain imaging.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Chikungunya virus (CHIKV) caused a major epidemic in La Réunion Island (2005-2006).
  • While typically benign, CHIKV infection can lead to severe neurological complications, including fatal outcomes.
  • Pediatric neurological involvement during chikungunya epidemics requires further investigation.

Purpose of the Study:

  • To describe the spectrum of neurological manifestations in a pediatric cohort during the La Réunion chikungunya epidemic.
  • To analyze clinical, laboratory, and imaging findings in children with chikungunya-related neurological disease.
  • To identify factors associated with severe outcomes and neurological sequelae.

Main Methods:

  • Retrospective, hospital-based case series of 30 pediatric patients.
  • Review of clinical data, cerebrospinal fluid (CSF) analyses, brain MRI, and electroencephalography (EEG).
  • Assessment of patient outcomes at discharge and 6 months post-discharge.

Main Results:

  • Neurologic manifestations included encephalitis (12), febrile seizures (10), meningeal syndrome (4), and acute encephalopathy (4).
  • CSF analyses were mostly unremarkable, with one case of acute disseminated encephalomyelitis; viral genome detection in CSF was inconsistent.
  • Brain MRI was abnormal in 5 of 14 patients; EEG findings were nonspecific. Two deaths and 5 cases of neurologic sequelae were reported.
  • Severe initial neurologic presentation and pathological brain MRI correlated with increased risk of sequelae or death.

Conclusions:

  • Chikungunya virus can cause a range of serious neurological conditions in children.
  • Early and severe neurological symptoms, along with abnormal brain imaging, are indicators of poor prognosis.
  • This highlights the importance of recognizing and managing chikungunya-associated neurological disease in pediatric populations.

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