Neurological Manifestations of Dengue Fever in Pediatric Patients: An Observational Descriptive Study at a Tertiary Health Care Centre

Abstract

Introduction: Dengue fever is a common mosquito-borne viral illness that may be complicated by neurological manifestations, especially in children. These complications, though less frequently reported, are associated with significant morbidity and mortality. Aims: To examine the distribution of patients' ages and genders who exhibit Dengue's neurological symptoms. To determine which neurological conditions such as encephalitis, seizures, Guillain-Barré Syndrome, and others are more prevalent. Materials & Methods: This observational and descriptive single-centre study was conducted at R. G. Kar Medical College and Hospital over a period of three years, from January 2022 to January 2025. The study included a total of 33 paediatric patients (up to 12 years of age) who had laboratory-confirmed dengue infection (by NS1 antigen, IgM/IgG ELISA, or PCR) and presented with neurological symptoms. Result: The mean age of patients was 8.7 ± 3.1 years, with a male-to-female ratio of 1.36:1. The most common neurological manifestations were seizures (42.4%) and encephalopathy (33.3%), both significantly associated with CNS involvement (p=0.001 and p=0.008 respectively). CSF pleocytosis was seen in 30.3% and abnormal MRI findings in 36.4% (p<0.05). Compared to children without neurological symptoms, those with neurological manifestations had significantly lower platelet counts and longer ICU stays. Full recovery was observed in 66.7%, while 18.2% had residual deficits and 15.1% succumbed to the illness. Conclusion: Neurological involvement in pediatric dengue fever is not uncommon and presents predominantly with seizures and encephalopathy. Early detection, neurodiagnostic evaluation, and intensive care support are crucial for improving outcomes and preventing long-term complications.