Dengue encephalitis

Last revised by Travis Fahrenhorst-Jones on 2 Feb 2023

Dengue encephalitis is a rare condition resulting from direct involvement of the central nervous system by the dengue virus, it is one of many viral encephalitides and flavivirus encephalitides.  

Dengue infection and dengue encephalitis, predominately occurs in tropical and subtropical areas of the world 1

Dengue encephalitis presents similar to other forms of encephalitis with non-specific symptoms such as headache, seizures and altered level of consciousness. 

Dengue virus is a mosquito-transmitted RNA virus belonging to the flavivirus genus. There are four serotypes, designated DENV1-DENV-4 1. The serotypes most commonly implicated in neurologic manifestations of dengue virus infection are DENV2 and DENV-3 2.

Dengue encephalitis typically involves the basal ganglia, thalami, cortical grey matter, and subcortical and deep white matter. Rarely, lesions are found in atypical locations such as the brainstem (particularly the substantia nigra), cerebellum, and hippocampus 1.

  • hyperattenuating intraparenchymal foci representing spontaneous macrohaemorrhages 1
  • T2: hyperintense
  • DWI/ADC: affected regions demonstrate restricted diffusion in most cases 1
  • SWI: microhemorrhages are commonly seen 1

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