• Francisco Javier Carod-Artal, Ole Wichmann, Jeremy Farrar, and Joaquim Gascón.
• Neurology Department, Raigmore Hospital, Inverness, UK; Medicine and Health Sciences Faculty, Universitat Internacional de Catalunya (UIC), Barcelona, Spain. Electronic address: javier.carodartal@nhs.net.
• Lancet Neurol. 2013 Sep 1; 12 (9): 906-919.

AbstractDengue is the second most common mosquito-borne disease affecting human beings. In 2009, WHO endorsed new guidelines that, for the first time, consider neurological manifestations in the clinical case classification for severe dengue. Dengue can manifest with a wide range of neurological features, which have been noted--depending on the clinical setting--in 0·5-21% of patients with dengue admitted to hospital. Furthermore, dengue was identified in 4-47% of admissions with encephalitis-like illness in endemic areas. Neurological complications can be categorised into dengue encephalopathy (eg, caused by hepatic failure or metabolic disorders), encephalitis (caused by direct virus invasion), neuromuscular complications (eg, Guillain-Barré syndrome or transient muscle dysfunctions), and neuro-ophthalmic involvement. However, overlap of these categories is possible. In endemic countries and after travel to these regions, dengue should be considered in patients presenting with fever and acute neurological manifestations.Copyright © 2013 Elsevier Ltd. All rights reserved.

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