Magnetic Resonance Imaging Brain Findings in Chikungunya Virus (CHIKV) Infection with Neurological Complication during Epidemic Outbreak

Neurol India. 2023 May-Jun;71(3):467-470. doi: 10.4103/0028-3886.378660.

Abstract

Background and objective: The Chikungunya virus is an alphavirus RNA of the family Togaviridae transmitted by the Aedes mosquito. We aim to report magnetic resonance imaging (MRI) brain findings for neurological complications at our institute during epidemic outbreak.

Materials and methods: A total of 43 seropositive cases of Chikungunya infection underwent MRI brain.

Results: Out of 43 patients, 27 (63%) had discrete and confluent supra-tentorial T2-weighted (T2W) and fluid-attenuated inversion recovery (FLAIR) hyper-intense white matter foci. A total of 14 patients (33%) showed multiple foci/areas of diffusion restriction, and four of these patients had infra-tentorial T2 & FLAIR hyper-intense foci with restricted diffusion. In three pediatric age group patients including two neonates, the pattern of involvement was diffuse white matter changes with restricted diffusion. In 30% cases, MRI was normal.

Conclusions: Detection of focal or confluent white matter hyper-intense foci with restricted diffusion on MRI in patients presenting with fever and neurological symptoms has potential to conclude the diagnosis of Chikungunya encephalitis, especially in epidemic settings.

Keywords: Chikungunya virus; MRI; diffusion-weighted imaging; focal and confluent white matter foci; polymerase chain reaction.

MeSH terms

  • Animals
  • Brain / diagnostic imaging
  • Brain / pathology
  • Chikungunya Fever* / complications
  • Chikungunya Fever* / diagnostic imaging
  • Chikungunya Fever* / epidemiology
  • Chikungunya virus* / genetics
  • Child
  • Disease Outbreaks
  • Humans
  • Infant, Newborn
  • Magnetic Resonance Imaging / methods