Appendix 5: List of cases classified as category A
Source (P=Pat.No.) / Patient / Diagnosis / Neurological symptoms [tfdo] / Initial symptoms / Etiologiesexcluded / CHIKV-testing
[tfdo] / CSF biochem.ª (cells/tp) [tfdo] / MRI
findings [tfdo] / EEG
findings [tfdo] / ENMG findings [tfdo]
1 / Nelson et al., 2014 [1] / m, 57 / Encephalitis / reduced LoC, tonic-clonic seizure [6] / fever, rash, arthralgia / Bact., HIV, Malaria, DENV, ZikaV, WNV, RVFV, YFV, MMR, HSV, Lues, Enterovirus, EBV / blood: rtPCR+ [7],
IgM+ [8], IgG+ [11] CSF: rtPCR- [7],
IgM+ [7] / Guillain-Barré CSF-Syndrome (4/196) [7] / incomplete suppression of CSF spaces along bilateral occipital lobes [7] / moderate diffuse slowing [7] / N/A
2 / Chusri et al., 2011 [2] / f, 27 / Encephalitis / altered mental status (mute, drowsy) [3] / fever, rash, arthralgia / Bact., Fungi, Tbc, HSV1/2, CMV, EBV, VZV, DENV, JEV / blood: IgM+ [7]
CSF: IgM+ [7] / transsudative CSF-Syndrome (90/70) [7] / FLAIR-hyperintens. in temporal & insular cortices w/o significant contrast-enhancement [7] / N/A / N/A
3 / Robin et al., 2008: P11 [3], Pellot et al., 2012: P2 [4] / f, 10 / Meningo- encephalitis / headache, reduced LoC, miosis, seizures, menin- gism, pyramidal syndrome [6] / fever, rash, arthralgia / Bact., EBV, HSV, Enterovirus, Mycoplasma, Leptospirosis / blood: rtPCR- [N/A],
IgM+ [N/A] CSF: rtPCR+ [N/A],
IgM+ [N/A] / exsudative CSF-Syndrome (120/31) [N/A] / T2-hyperintensities in periventricular white matter; severe brain edema in follow-up [N/A] / N/A / N/A
4 / Lemant et al., 2008: P11 [5], Gerardin et al., 2015: P32 [6] / f, 83 / Encephalitis / reduced LoC (GCS 13) [2] / fever, rash, arthralgia / HSV / blood: rtPCR+ [5],
IgM+ [5]
CSF: rtPCR- [N/A],
IgM+ [N/A] / transsudative CSF-Syndrome (90/60) [N/A] / N/A / diffuse slowing [N/A] / N/A
sd
Abbreviations: P=patient; m=male; f=female; tfdo= time from disease onset (to neurological symptoms, to day of laboratory exam etc.). Disease onset is defined as occurrence of initial symptoms such as fever, rash and arthralgia; LoC=Level of Consciousness; HSV=Herpes simplex virus; EBV=Epstein-Barr virus; VZV=Varicella zoster virus; CMV=Cytomegalovirus; HIV=Human immunodeficiency virus; HTLV=Human T-lymphotropic virus; MMR=measles, mumps and rubella; DENV=Dengue virus; ZikaV=Zika virus; WNV=West Nile virus; RVFV=Rift Valley fever virus; YFV=Yellow fever virus; JEV=Japanese encephalitis virus; HAV/HBV/HCV=Hepatitis A/B/C virus; CSF=Cerebrospinal Fluid; tp= total protein; EEG=Electroencephalogram; ENMG=Electroneuromyography.
ªCSF basic biochemistry was additionally coded into CSF-syndromes based on cells and total protein: ‘normal’ (<5/µl | 5-40mg/dl), ’exsudative’ (>100/µl | slightly elevated), ’transsudative’ (5-100/µl | <100mg/dl), ’Guillain-Barré’=cytoalbuminologic dissociation (0-50/µl | 100-200mg/dl), ’Nonne-Froin’ (<5/µl | >100-200mg/dl), ’immunoactive’ (5-50/µl | <80mg/dl)[7,8]
excluded / CHIKV-testing
[tfdo] / CSF biochem.ª (cells/tp) [tfdo] / MRI
findings [tfdo] / EEG
findings [tfdo] / ENMG findings [tfdo]
5 / Lemant et al.,
2008: P12 [5], Gerardin et al.,
2015: P14 [6] / f, 56 / Encephalitis / headache, reduced & fluctuating LoC, seizures, right sided hemipleg. [3] / only fever / HSV, HIV, Malaria, Leptospirosis / blood: IgM+ [N/A] CSF: IgM+ [N/A] / exsudative CSF-Syndrome (180/117) [3] / possible pontine lesion [11] / diffuse slowing [3] / N/A
6 / Gerardin et al.,
2015: P4 [6] / m, 1m. / Encephalitis / altered mental status [N/A] / only fever / HSV, HIV, Bact., Malaria, paraneoplastic-related encephalitis / blood: rtPCR+ [N/A],
IgM- [N/A] CSF: rtPCR+ [N/A] / transsudative CSF-Syndrome (32/85) [N/A] / N/A / scattered theta activity and spike waves; seizures in follow-up [N/A] / N/A
7 / Wielanek et al., 2007 [9], Lebrun et al., 2009 [10], Gaüzère et al., 2011 [11] / f, 51 / GBS / bilat. facial palsy, quadriparesis, global areflexia [14] / fever, rash, arthralgia / C. jejuni, M. pneumoniae, CMV, EBV, DENV, HIV / blood: rtPCR- [17],
IgM+ [17], IgG+ [17]
CSF: IgM+ [17],
IgG+ [17] / Guillain-Barré CSF-Syndrome (5/144) [17] / N/A / N/A / axonal damage and demyelinating [35]
8 / Wielanek et al., 2007 [9], Lebrun et al., 2009 [10],
Gaüzère et al., 2011 [11] / f, 48 / GBS / symmetr. para- paresis, facial diplegia, proprio- ceptive ataxia and areflexia [7] / fever, rash, arthralgia / C. jejuni, M.pneumoniae, C. pneumoniae, CMV, EBV, DENV, HIV / blood: rtPCR- [7],
IgM+ [7], IgG+ [7] CSF: rtPCR- [11],
IgM+ [7], IgG+ [7] / Guillain-Barré CSF-Syndrome (10/200) [7] / N/A / N/A / axonal damage and demyelinating [11]
9 / Lemant et al., 2008: P17 [5] / f, 55 / GBS / flaccid tetraparesis, facial neuropathy, hyporeflexia, hypoventilation [8] / fever, arthralgia / DENV, CMV, EBV, HAV, HBV, HCV, HTLV, HIV, Myco- plasma, Chlamydia / blood: IgM+ [8]
CSF: rtPCR- [N/A],
IgM+ [N/A] / Guillain-Barré CSF-Syndrome (0/160) [N/A] / N/A / N/A / demyelinating [N/A]
.
Note: Patients number three, four, five, seven and eight have been described twice respectively three times in the literature found in the course of the systematic review.
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