Bilateral Abducens Nerve Paresis: A Rare Manifestation of Dengue Fever
Dengue fever is endemic in over 100 countries, with the majority of cases reported in the World Health Organisation (WHO) regions of the Americas, Southeast Asia and the Western Pacific. Dengue fever is endemic in almost every state in India, and it is the leading cause of hospitalisation. The prese...
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JCDR Research and Publications Private Limited
2022-09-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| author | Pragati Garg Swarastra P Singh Archana Verma Abhay Singh Vinoth Gnana Chellaiyan |
| author_facet | Pragati Garg Swarastra P Singh Archana Verma Abhay Singh Vinoth Gnana Chellaiyan |
| author_sort | Pragati Garg |
| collection | DOAJ |
| description | Dengue fever is endemic in over 100 countries, with the majority of cases reported in the World Health Organisation (WHO) regions of the Americas, Southeast Asia and the Western Pacific. Dengue fever is endemic in almost every state in India, and it is the leading cause of hospitalisation. The presentation may vary from being asymptomatic to having mild syndrome. Among other neuro-ophthalmological manifestations, oculomotor neuropathy, optic neuropathy and unilateral abducens nerve palsy has been reported but to the best of authors' knowledge this is the first reported case of dengue virus related type three internuclear ophthalmoplegia. A 47-year-old male patient presented with complaints of fever on and off for the last three days along with speech defects. At admission his blood pressure was 120/86 mmHg, pulse rate was 96 per minute. Oxygen saturation (SpO2) was 94%. He was thoroughly investigated for various viral and bacterial infections, none of which was detected in Polymerase Chain Reaction (PCR) serum test. Hepatitis B virus surface antigen (HBsAg), antibody against Hepatitis C Virus (anti-HCV), antibody against Human Immunodeficiency Virus type 1/2 (anti-HIV 1/2) were all negative. Anti-dengue virus Immunoglobulin M (IgM) antibody was found to be positive. The patient complained of double vision and on examination diplopia in both lateral gaze with maximum separation of images in right gaze. Due to the wider range of possible presentations, it is imperative to consistently follow-up with all dengue patients to check for any neurological sequalae. |
| first_indexed | 2024-04-10T08:45:29Z |
| format | Article |
| id | doaj.art-1739c9b94f0f4c2ca654e5560fa88882 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-04-10T08:45:29Z |
| publishDate | 2022-09-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-1739c9b94f0f4c2ca654e5560fa888822023-02-22T08:13:36ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2022-09-01169OD07OD0810.7860/JCDR/2022/56930.16843Bilateral Abducens Nerve Paresis: A Rare Manifestation of Dengue FeverPragati Garg0Swarastra P Singh1Archana Verma2Abhay Singh3Vinoth Gnana Chellaiyan4Professor, Department of Ophthalmology, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, India.Associate Professor, Department of Ophthalmology, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, India.Professor, Department of Neurology, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, India.Assistant Professor, Department of Community Medicine, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, India.Associate Professor, Department of Community Medicine, Chettinad Hospital and Research Institute, Chettinad Academy and Research Education, Kelambakkam, Tamil Nadu, India.Dengue fever is endemic in over 100 countries, with the majority of cases reported in the World Health Organisation (WHO) regions of the Americas, Southeast Asia and the Western Pacific. Dengue fever is endemic in almost every state in India, and it is the leading cause of hospitalisation. The presentation may vary from being asymptomatic to having mild syndrome. Among other neuro-ophthalmological manifestations, oculomotor neuropathy, optic neuropathy and unilateral abducens nerve palsy has been reported but to the best of authors' knowledge this is the first reported case of dengue virus related type three internuclear ophthalmoplegia. A 47-year-old male patient presented with complaints of fever on and off for the last three days along with speech defects. At admission his blood pressure was 120/86 mmHg, pulse rate was 96 per minute. Oxygen saturation (SpO2) was 94%. He was thoroughly investigated for various viral and bacterial infections, none of which was detected in Polymerase Chain Reaction (PCR) serum test. Hepatitis B virus surface antigen (HBsAg), antibody against Hepatitis C Virus (anti-HCV), antibody against Human Immunodeficiency Virus type 1/2 (anti-HIV 1/2) were all negative. Anti-dengue virus Immunoglobulin M (IgM) antibody was found to be positive. The patient complained of double vision and on examination diplopia in both lateral gaze with maximum separation of images in right gaze. Due to the wider range of possible presentations, it is imperative to consistently follow-up with all dengue patients to check for any neurological sequalae.https://jcdr.net/articles/PDF/16843/56930_CE(OM)_F[SH]_PF1(SC_SS)_PFA(SC_KM)_PN(KM).pdfdiplopiaopthalmologiaslurred speech |
| spellingShingle | Pragati Garg Swarastra P Singh Archana Verma Abhay Singh Vinoth Gnana Chellaiyan Bilateral Abducens Nerve Paresis: A Rare Manifestation of Dengue Fever Journal of Clinical and Diagnostic Research diplopia opthalmologia slurred speech |
| title | Bilateral Abducens Nerve Paresis: A Rare Manifestation of Dengue Fever |
| title_full | Bilateral Abducens Nerve Paresis: A Rare Manifestation of Dengue Fever |
| title_fullStr | Bilateral Abducens Nerve Paresis: A Rare Manifestation of Dengue Fever |
| title_full_unstemmed | Bilateral Abducens Nerve Paresis: A Rare Manifestation of Dengue Fever |
| title_short | Bilateral Abducens Nerve Paresis: A Rare Manifestation of Dengue Fever |
| title_sort | bilateral abducens nerve paresis a rare manifestation of dengue fever |
| topic | diplopia opthalmologia slurred speech |
| url | https://jcdr.net/articles/PDF/16843/56930_CE(OM)_F[SH]_PF1(SC_SS)_PFA(SC_KM)_PN(KM).pdf |
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