Table 3.
Reports of perinatally acquired neurological disease associated with chikungunya virus
| Year of case(s), Location | No. | Evidence for Chikungunya | PP | CSF | Neurological Features | Treatmenta and Outcome |
|---|---|---|---|---|---|---|
| Perinatal encephalopathy (n = 35) | ||||||
| 2005‐2006, Réunion37 | 5 | Ne: PCR CSF | … | … | Fulfilled International Encephalitis Consortium criteria for encephalitis | Cerebral palsy and blindness (1), poor neurodevelopmental performance (1) |
| 2005‐206, Mayotte36 | 3 | Ne&M: PCR/IgM CSF/ser | … | … | Unknown | Unknown |
| 2005‐2006, Réunion112 | 4 | Ne&M: PCR/IgM ser | 3‐7 d | … | Seizures; EEG consistent with encephalitis | Survived |
| 2010, India113 | 2 | Ne&M: PCR ser | 5 d | NAD | Altered sensorium, apnoeic seizures | Spastic diplegia, epilepsy, mental retardation |
| 3 d | NAD | Apnoeic seizures, lethargy | ↓tone, cerebral palsy, ↓vision, mental retardation | |||
| 2014‐2015, Colombia31 | 2 | Ne&M: PCR/IgM ser | … | … | Unknown | Unknown |
| 2014‐2015, El Salvador, Colombia, and Dom Rep114 | 12 | Ne: PCR/IgM ser/CSF (10) | … | … | Unknown | Unknown |
| 2015, Brazil115 | 1 | Ne: PCR CSF, ser, urine, saliva | 6 d | WCC N, prot↑ | Seizures; abnormal MRI brain | Anticonvulsants. Improved at 17 d |
| 2015, Honduras52 | 3 | PCR ser | … | … | Unknown | Unknown |
| 2016, India116 | 2 | Ne&M: IgM ser | 5 d | … | Dizygotic twins; both had seizures, required ventilation, thrombocytopenia; abnormal MRI brain | Both improved and discharged at 24 d |
| 2016c, Brazil117 | 1 | Ne: PCR CSF; M: IgM ser | 4 | WCC ↑, prot ↑ | Prostration, lethargy, seizures, required ventilation, thrombocytopenia; abnormal MRI brain and EEG | Cerebral palsy, microcephaly, epilepsy at 1 y |
| Perinatal brain haemorrhage (n = 7) | ||||||
| 2005‐206, Réunion105 | 2 | Ne&M: PCR/IgM CSF/ser | … | … | DIC, transient scattered parenchymal petechiae (1), cerebellar haematoma (1) | Unknown |
| 2005‐2006, Réunion97 | 2 | Ne&M: PCR/IgM CSF/ser | … | … | Unknown | Unknown |
| 2005‐206, Réunion112 | 1 | Ne&M: PCR and IgM ser | 3‐7 d | … | Severe thrombocytopenia, cerebral haemorrhage | Survived |
| 2015, Brazil118 | 1 | Nil | 4 d | NAD | Intraventricular bleed (cranial US), lethargy | Improved, discharged after 17 d |
| 2012, India119 | 1 | M: IgM ser; Ne: NAD | 3 | NAD | Lethargic, severe thrombocytopenia, focal bleeds basal ganglia, and subcortical areas | Fully recovered |
| Perinatal other (n = 18) | ||||||
| 2005‐2006, Réunion97 | 17b | Ne&M: PCR/IgM CSF/ser | … | … | Seizures (6); hypotonia (17) | Unknown |
| 2005‐2006, Mayotte36 | 1 | Ne&M: PCR/IgM CSF/ser | … | … | Hypotonia | Unknown |
Abbreviations: …, data unavailable; CSF, cerebrospinal fluid; DIC, disseminated intravascular coagulation; Dom Rep, Dominican Republic; EEG, electroencephalogram; IgM, immunoglobulin M; M, mother; MRI, magnetic resonance imaging; N, normal; NAD, no abnormality detected; Ne, neonate; PCR, polymerase chain reaction; PP, onset of neurological disease days postpartum; prot, protein (↑, >0.4 g for adults, >1.5 g for neonates); ser, serum; WCC, white cell count (↑, >5 cells/μL); VEP, visual evoked potential.
Treatments are in italics.
At least 17 patients; unclear whether seizures and hypotonia were seen in the same or different patients.
Patient had a subarachnoid haemorrhage and optic atrophy in addition to encephalitis.