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Published in: BMC Infectious Diseases 1/2018

Open Access 01-12-2018 | Case report

Multifocal motor neuropathy presenting as a post-infectious complication of dengue: a CASE report

Authors: Rakitha Higgoda, Dilshan Perera, Kanapathipillai Thirumavalavan

Published in: BMC Infectious Diseases | Issue 1/2018

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Abstract

Background

Dengue infection is an endemic illness in the tropics and it is associated with a wide variety of post infectious complications. With the increasing prevalence of dengue infection in endemic regions, post-infectious neurological complications following dengue infection are now been reported more frequently. We report a patient who developed multifocal motor neuropathy (MMN) with conduction blocks following dengue infection during the immediate post-infectious period. MMN is a rare neurological disorder with an autoimmune etiology and to best of our knowledge this is the first reported case of MMN occurring following dengue infection as a post dengue neurological complication.

Case presentation

A 20 year old Sri Lankan male who was treated for serologically confirmed dengue infection presented to us with 1 month history of bilateral hand weakness which has started 5 days after the dengue infection (5 days after the discharge). On examination he had asymmetrical motor weakness of the hands and to a lesser degree in feet. There was no sensory impairment. Nerve conduction studies confirmed MMN with conduction blocks. He was started on intravenous immunoglobulin therapy for which he showed a good response.

Conclusion

The authors report the first case of MMN complicating dengue fever in a previously healthy male from Sri Lanka. Thus it should be borne in mind that although rare, MMN can occur as a post-infectious complication of dengue fever.
Literature
2.
go back to reference Verma R, Sharma P, Garg RK, Atam V, et al. Neurological complications of dengue fever: experience from a tertiary center of North India. Ann Indian Acad Neurol. 2011 Oct-Dec;14(4):272–8.CrossRefPubMedPubMedCentral Verma R, Sharma P, Garg RK, Atam V, et al. Neurological complications of dengue fever: experience from a tertiary center of North India. Ann Indian Acad Neurol. 2011 Oct-Dec;14(4):272–8.CrossRefPubMedPubMedCentral
3.
6.
go back to reference Herath HM, Hewavithana JS, De Silva CM. Cerebral vasculitis and lateral rectus palsy – two rare central nervous system complications of dengue fever: two case reports and review of the literature. J Med Case Rep. 2018;12:100.CrossRefPubMedPubMedCentral Herath HM, Hewavithana JS, De Silva CM. Cerebral vasculitis and lateral rectus palsy – two rare central nervous system complications of dengue fever: two case reports and review of the literature. J Med Case Rep. 2018;12:100.CrossRefPubMedPubMedCentral
7.
go back to reference Nagale SV, Bosch EP. Multifocal motor neuropathy with conduction block: current issues in diagnosis and treatment. Semin Neurol. 2003 Sep;23(3):325–34.CrossRefPubMed Nagale SV, Bosch EP. Multifocal motor neuropathy with conduction block: current issues in diagnosis and treatment. Semin Neurol. 2003 Sep;23(3):325–34.CrossRefPubMed
8.
go back to reference Chaudhry V, Swash M. Multifocal motor neuropathy: is conduction block essential? Neurology. 2006 Aug;67(4):558–9.CrossRefPubMed Chaudhry V, Swash M. Multifocal motor neuropathy: is conduction block essential? Neurology. 2006 Aug;67(4):558–9.CrossRefPubMed
9.
go back to reference European Federation of Neurological Societies. Peripheral nerve society guideline on management of multifocal motor neuropathy. Report of a joint task force of the European Federation of Neurological Societies and the peripheral nerve society-first revision. J Peripher Nerv Syst. 2010 Dec;15(4):295–301.CrossRef European Federation of Neurological Societies. Peripheral nerve society guideline on management of multifocal motor neuropathy. Report of a joint task force of the European Federation of Neurological Societies and the peripheral nerve society-first revision. J Peripher Nerv Syst. 2010 Dec;15(4):295–301.CrossRef
10.
go back to reference Bromberg MB, Franssen H. Practical rules for electrodiagnosis in suspected multifocal motor neuropathy. J Clin Neuromuscul Dis. 2015 Mar;16(3):141–52.CrossRefPubMed Bromberg MB, Franssen H. Practical rules for electrodiagnosis in suspected multifocal motor neuropathy. J Clin Neuromuscul Dis. 2015 Mar;16(3):141–52.CrossRefPubMed
11.
go back to reference Nobile-Orazio E, Giannotta C, Musset L, Messina P, Léger JM. Sensitivity and predictive value of anti-GM1/galactocerebroside IgM antibodies in multifocal motor neuropathy. J Neurol Neurosurg Psychiatry. 2014 Jul;85(7):754–8.CrossRefPubMed Nobile-Orazio E, Giannotta C, Musset L, Messina P, Léger JM. Sensitivity and predictive value of anti-GM1/galactocerebroside IgM antibodies in multifocal motor neuropathy. J Neurol Neurosurg Psychiatry. 2014 Jul;85(7):754–8.CrossRefPubMed
12.
go back to reference Willison HJ, Yuki N. Peripheral neuropathies and anti-glycolipid antibodies. Brain. 2002;125:2591–625.CrossRefPubMed Willison HJ, Yuki N. Peripheral neuropathies and anti-glycolipid antibodies. Brain. 2002;125:2591–625.CrossRefPubMed
13.
go back to reference Van Sorge NM, Yuki N, Jansen MD, et al. Leukocyte and complement activation by GM1-specific antibodies is associated with acute motor axonal neuropathy in rabbits. J Neuroimmunol. 2007;182:116–23.CrossRefPubMed Van Sorge NM, Yuki N, Jansen MD, et al. Leukocyte and complement activation by GM1-specific antibodies is associated with acute motor axonal neuropathy in rabbits. J Neuroimmunol. 2007;182:116–23.CrossRefPubMed
14.
go back to reference Susuki K, Rasband MN, Tohyama K, et al. Anti-GM1 antibodies cause complement-mediated disruption of sodium channel clusters in peripheral motor nerve fibers. J Neurosci. 2007;27(15):3956–67.CrossRefPubMed Susuki K, Rasband MN, Tohyama K, et al. Anti-GM1 antibodies cause complement-mediated disruption of sodium channel clusters in peripheral motor nerve fibers. J Neurosci. 2007;27(15):3956–67.CrossRefPubMed
15.
go back to reference Cocito D, Bergamasco B, Tavella A, et al. Multifocal motor neuropathy during treatment with infliximab. J Peripher Nerv Syst. 2005;10(4):386–7.CrossRefPubMed Cocito D, Bergamasco B, Tavella A, et al. Multifocal motor neuropathy during treatment with infliximab. J Peripher Nerv Syst. 2005;10(4):386–7.CrossRefPubMed
16.
go back to reference Rodriguez-Escalera C, Belzunegui J, Lopez-Dominguez L, Gonzalez C, Figueroa M. Multifocal motor neuropathy with conduction block in a patient with rheumatoid arthritis on infliximab therapy. Rheumatology (Oxford). 2005;44(1):132–3.CrossRef Rodriguez-Escalera C, Belzunegui J, Lopez-Dominguez L, Gonzalez C, Figueroa M. Multifocal motor neuropathy with conduction block in a patient with rheumatoid arthritis on infliximab therapy. Rheumatology (Oxford). 2005;44(1):132–3.CrossRef
17.
go back to reference Singer OC, Otto B, Steinmetz H, Ziemann U. Acute neuropathy with multiple conduction blocks after TNFalpha monoclonal antibody therapy. Neurology. 2004;63(9):1754.CrossRefPubMed Singer OC, Otto B, Steinmetz H, Ziemann U. Acute neuropathy with multiple conduction blocks after TNFalpha monoclonal antibody therapy. Neurology. 2004;63(9):1754.CrossRefPubMed
20.
go back to reference Yuki N, Watanabe H, Nakajima T, Spath PJ. IVIG blocks complement deposition mediated by anti-GM1 antibodies in multifocal motor neuropathy. J Neurol Neurosurg Psychiatry. 2011;82(1):87–91.CrossRefPubMed Yuki N, Watanabe H, Nakajima T, Spath PJ. IVIG blocks complement deposition mediated by anti-GM1 antibodies in multifocal motor neuropathy. J Neurol Neurosurg Psychiatry. 2011;82(1):87–91.CrossRefPubMed
Metadata
Title
Multifocal motor neuropathy presenting as a post-infectious complication of dengue: a CASE report
Authors
Rakitha Higgoda
Dilshan Perera
Kanapathipillai Thirumavalavan
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2018
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-018-3334-z

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