Neurologic manifestations of pediatric chikungunya infection

Chikungunya virus, a mosquito-borne arbovirus, was responsible for a massive epidemic in La Reunion Island during 2005 to 2006. The disease is usually benign, but neurologic involvement, with sometimes fatal outcome, has been described. We report a retrospective hospital-based pediatric series of 30 children (23 boys and 7 girls) who presented neurologic manifestations of chikungunya Such as encephalitis (n = 12), febrile Seizures (n = 10), meningeal syndrome (n = 4), and acute encephalopathy (n = 4). Cerebrospinal fluid biological and cytological analyses (11 = 23) were unremarkable except for I case of acute disseminated encephalomyelitis. The presence of viral genome in cerebrospinal fluid,vas inconstantly positive. Brain magnetic resonance imaging (MRI) scans (n = 14) were abnormal in 5 cases. Electroencephalography was nonspecific. Two patients died. At discharge and 6 months later, 5 children had neurologic sequelae. Patients with initial severe neurologic presentation and having pathological brain MRI had more sequelae or fatal disease.