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Published on: September 12, 2016
Post-dengue transverse myelitis: a challenging case of neurological and therapeutic evidence
Bianca Frigo Pires1, Caroline Goulart Nunes de Souza2, Eduardo Coviello Mendes de Campos2
1Department of Neurosurgery, Faculdade de Medicina de Marília, Avenida Monte Carmelo, 800, Fragata District, Marília - State of São Paulo, 175190-30, Brazil.
Introduction:
Dengue is an arbovirus with significant global prevalence that can lead to severe neurological complications, such as longitudinally extensive transverse myelitis (LEMT).
Case Report:
We describe a 36-year-old man who developed sudden paraparesis and urinary retention approximately ten days after dengue infection. MRI revealed longitudinal hyperintense lesions in the cervical and thoracic spinal cord. Cerebrospinal fluid analysis revealed an inflammatory pattern and dengue serology was positive. The patient was treated with intravenous methylprednisolone and rehabilitation, leading to gradual neurological improvement and functional recovery.
Discussion:
Post-dengue transverse myelitis may result from parainfectious or post-infectious autoimmune mechanisms, often accompanied by demyelination and spinal cord inflammation. The low rate of DENV IgM in the CSF reinforces the immune-mediated hypothesis. Prognosis varies depending on the early intervention and the extent of spinal injury. Underreporting remains a challenge, and future studies should explore biomarkers and develop standardized management protocols.
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