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- Title
Clinical and magnetic resonance imaging patterns of extensive Chikungunya virus–associated myelitis.
- Authors
Rueda-Lopes, Fernanda Cristina; da Cruz, Luiz Celso Hygino; Fontes, Fabrícia Lima; Herlinger, Alice Laschuk; da Costa Ferreira Junior, Orlando; de Aguiar, Renato Santana; Vasconcelos, Claudia Cristina Ferreira; do Nascimento, Osvaldo José Moreira; Alves-Leon, Soniza Vieira
- Abstract
Chikungunya fever is an arbovirus infection transmitted by the same mosquito vector of dengue and Zika virus. Besides high fever, common clinical symptoms include articular pain and general malaise. Neurological involvement is unusual, but some patients may develop peripheral and central nervous system involvement, including meningoencephalitis, myelitis, Guillain-Barré syndrome, and acute disseminated encephalomyelitis. We present three cases of Chikungunya fever complicated with extensive myelitis. The spinal cord magnetic resonance imaging (MRI) pattern is characterized by multiple dotted-like and longitudinal hyperintense lesions, with contrast enhancement, mostly distributed in the peripheral regions of the spinal cord. It seems that these lesions are mostly located in the perivascular spaces (PVS), related or not to virus attack. Involvement of brain PVS can also be demonstrated, as shown in two of the cases described. Considering the MRI pattern, extensive spinal cord lesion should include Chikungunya as a differential diagnosis, especially during an outbreak.
- Subjects
MAGNETIC resonance imaging; CHIKUNGUNYA; ARBOVIRUS diseases; MYELITIS; POSTVACCINAL encephalitis; PERIPHERAL nervous system
- Publication
Journal of NeuroVirology, 2021, Vol 27, Issue 4, p616
- ISSN
1355-0284
- Publication type
Article
- DOI
10.1007/s13365-021-00962-4