Neurological complications following acute viral conjunctivitis: a new profile

A study of eleven patients presenting with neurological complications following acute viral conjunctivitis, mostly haemorrhagic, is reported and the literature reviewed. A Guillain-Barre syndrome-like profile was seen in six patients while the remaining had features of radiculomyelitis. Besides asymmetrical neurological deficits, protein cell reaction and residual muscle wasting, the occurrence of dysautonomias was the striking feature noted in the patients with a Guillain-Barre syndrome-like profile. The dysautonomic features included fatal paroxysmal hypertensive and hypotensive crises in one patient and self limiting tachycardias, episodic profuse sweating, abnormal expiration-inspiration ratio and valsalva ratio in four patients. High antibody titers to EV-70 virus were seen in five patients. A follow up of one and a half year revealed poor neurologic recovery in patients with radiculomyelitis as compared to good functional recovery in others. The importance of early recognition and appropriate treatment of dysautonomias is emphasised. The probable aetiopathogenesis of the neurological complications including dysautonomias is discussed.