Affiliations 

  • 1 Department of Neurology, Victor Babes University of Medicine and Pharmacy Timisoara, Timișoara, Romania
  • 2 Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
  • 3 Observatorio de Salud, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
  • 4 Neurology Unit, Department of Medicine, Faculty of Medicine, University Kebangsaan, Kuala Lumpur, Malaysia
  • 5 Department of Medicine, Faculty of Medicine, Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
  • 6 Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
  • 7 Department of Neurology, Shree Krishna Hospital Pramukhswami Medical College, Bhaikaka University, Karamsad, India
Mov Disord, 2025 Feb 08.
PMID: 39921518 DOI: 10.1002/mds.30142

Abstract

Movement disorders after dengue virus (DENV) infection have been increasingly recognized. We aimed to synthesize the clinical and paraclinical characteristics, treatment responses, and outcomes of these neurologic complications. We systematically reviewed PubMed, Embase, Scopus, and LILACS databases up to September 2023 following a published protocol. We identified 73 cases of DENV-induced movement disorders. Cerebellar ataxia was the most common, followed by parkinsonism, opsoclonus-myoclonus-ataxia syndrome, and dystonia. Movement disorders typically developed within 14 days of DENV infection and were associated with a range of neurological symptoms, including cognitive impairment and psychiatric disturbances. Neuroimaging studies frequently showed abnormalities in the basal ganglia and brainstem. Treatment varied depending on the specific movement disorder and included corticosteroids, intravenous immunoglobulin, and symptomatic medications. Whereas a handful of cases met the criteria for acute encephalitis, many lacked sufficient data to establish a definitive diagnosis. Para-infectious and postinfectious immune-mediated movement disorders were also reported. A rare case of chronic progressive panencephalitis due to DENV infection highlights the potential for long-term neurological consequences. Other DENV-related complications, such as stroke, pituitary apoplexy, subacute thyroiditis, and metabolic disturbances, can also cause movement disorders. We emphasize the importance of recognizing the diverse neurological manifestations of DENV infection and the need for further research to improve our understanding of the underlying mechanisms and optimize treatment strategies. We propose a more rigorous approach to determining the causality between infection and movement disorder, demanding stronger evidence beyond mere association and advocating for targeted research to fill the existing knowledge gaps. © 2025 International Parkinson and Movement Disorder Society.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.