Dengue Infection Related Acute Disseminated Encephalomyelitis(ADEM)-Case Series

Abstract

Spectrumof Dengue infection is getting wider with time. Expandeddengue syndromes is a large umbrella to cover atypical manifestationofdengueinfection.Denguecancauseneurologicalinvolvementbyen-cephalopathy, encephalitis and Acute disseminated encephalomyelitis(ADEM), whereas the later is the rarest one.In this case series we describe 5 cases who developed ADEM asa sequalae of dengue infection. The median days from dengue in-fection to development of neurological symptoms was11 days.Age range was (22-57) years. Magnetic resonance Imaging (MRI) ofall patients showed bilateral white matter involvement suggestive ofADEM. Slightly raised CSF proteins was universal to all patients. Mildlymphocytic pleocytosis was observed in 2 patients. None respondedto high dose steroids. Two patients were offered Plasma exchange.Outcome was poor, all patients died due to brain herniation