Sir, the report on "spontaneously resolving cerebellar syndrome as a
sequelae of dengue viral infection" is very interesting [1]. In fact,
neurological complication of dengue is not common but it can be detectable
[2]. The spontaneously resolving cerebellar syndrome in this report is
questionable for the relationship to dengue. Based on the previous study
from Thailand, the spontaneously resolving pathology of cerebellum was not
detected [3]. Although virus can be detected at cerebellum it is usually
identified in death cases [3 - 4].. The case of spontaneously resolving
cerebellar syndrome is usually identified in the patients with concurrent
infection between dengue and Epstein-Barr virus infection [5]. The
interesting topic is whether there is any interaction during co-infection
that contribute to observed cerebellar pathology.
References
1. Weeratunga PN, Caldera HP, Gooneratne IK, Gamage R, Perera WS,
Ranasinghe GV, Niraj M. Spontaneously resolving cerebellar syndrome as a
sequelae of dengue viral infection: a case series from Sri Lanka. Pract
Neurol. 2013 Jul 9. [Epub ahead of print]
2. Wiwanitkit V. Dengue fever: diagnosis and treatment. Expert Rev Anti
Infect Ther. 2010 Jul;8(7):841-5.
3. Wiwanitkit V. Magnitude and pattern of neurological pathology in fatal
dengue hemorrhagic fever: a summary of Thai cases. Neuropathology. 2005
Dec;25(4):398.
4. Ramos C, S?nchez G, Pando RH, Baquera J, Hern?ndez D, Mota J, Ramos J,
Flores A, Llaus?s E. Dengue virus in the brain of a fatal case of
hemorrhagic dengue fever. J Neurovirol. 1998 Aug;4(4):465-8.
5. Karunarathne S, Udayakumara Y, Fernando H. Epstein-Barr virus co-
infection in a patient with dengue fever presenting with post-infectious
cerebellitis: a case report. J Med Case Rep. 2012 Jan 30;6(1):43.
Conflict of Interest:
None declared
Sir, the report on "spontaneously resolving cerebellar syndrome as a sequelae of dengue viral infection" is very interesting [1]. In fact, neurological complication of dengue is not common but it can be detectable [2]. The spontaneously resolving cerebellar syndrome in this report is questionable for the relationship to dengue. Based on the previous study from Thailand, the spontaneously resolving pathology of cerebellum was not detected [3]. Although virus can be detected at cerebellum it is usually identified in death cases [3 - 4].. The case of spontaneously resolving cerebellar syndrome is usually identified in the patients with concurrent infection between dengue and Epstein-Barr virus infection [5]. The interesting topic is whether there is any interaction during co-infection that contribute to observed cerebellar pathology.
References 1. Weeratunga PN, Caldera HP, Gooneratne IK, Gamage R, Perera WS, Ranasinghe GV, Niraj M. Spontaneously resolving cerebellar syndrome as a sequelae of dengue viral infection: a case series from Sri Lanka. Pract Neurol. 2013 Jul 9. [Epub ahead of print] 2. Wiwanitkit V. Dengue fever: diagnosis and treatment. Expert Rev Anti Infect Ther. 2010 Jul;8(7):841-5. 3. Wiwanitkit V. Magnitude and pattern of neurological pathology in fatal dengue hemorrhagic fever: a summary of Thai cases. Neuropathology. 2005 Dec;25(4):398. 4. Ramos C, S?nchez G, Pando RH, Baquera J, Hern?ndez D, Mota J, Ramos J, Flores A, Llaus?s E. Dengue virus in the brain of a fatal case of hemorrhagic dengue fever. J Neurovirol. 1998 Aug;4(4):465-8. 5. Karunarathne S, Udayakumara Y, Fernando H. Epstein-Barr virus co- infection in a patient with dengue fever presenting with post-infectious cerebellitis: a case report. J Med Case Rep. 2012 Jan 30;6(1):43.
Conflict of Interest:
None declared