The neurological sequelae of pandemics and epidemics
- PDF / 4,397,959 Bytes
- 27 Pages / 595.276 x 790.866 pts Page_size
- 29 Downloads / 171 Views
REVIEW
The neurological sequelae of pandemics and epidemics Fernanda Valerio1 · Daniel P. Whitehouse1 · David K. Menon1,2 · Virginia F. J. Newcombe1,2 Received: 30 June 2020 / Revised: 3 October 2020 / Accepted: 7 October 2020 © The Author(s) 2020
Abstract Neurological manifestations in pandemics frequently cause short and long-term consequences which are frequently overlooked. Despite advances in the treatment of infectious diseases, nervous system involvement remains a challenge, with limited treatments often available. The under-recognition of neurological manifestations may lead to an increase in the burden of acute disease as well as secondary complications with long-term consequences. Nervous system infection or dysfunction during pandemics is common and its enduring consequences, especially among vulnerable populations, are frequently forgotten. An improved understanding the possible mechanisms of neurological damage during epidemics, and increased recognition of the possible manifestations is fundamental to bring insights when dealing with future outbreaks. To reverse this gap in knowledge, we reviewed all the pandemics, large and important epidemics of human history in which neurological manifestations are evident, and described the possible physiological processes that leads to the adverse sequelae caused or triggered by those pathogens. Keywords CNS infections · Peripheral neuropathies · Pandemics/history · Meningitis · Encephalitis
Introduction Pandemics are large-scale outbreaks of infectious disease that can cause an excess in morbidity and mortality globally, or at least over a wide geographic area, and lead to socioeconomic disruption. Increase in global travel, urbanisation, climate change, environmental degradation, displacement and consumption of wild animals are factors thought to have increased the likelihood of pandemics during the past century [79]. The majority of pathogens responsible for outbreaks can cause neurologic illness, which are frequently overlooked, under-reported and under-diagnosed. Even in tertiary centres of developed countries, up to 30% of patients with a CNS infection never receive an etiological diagnosis [135], and in low resource settings lacking diagnostic tools, neurological manifestations are often poorly characterised. Aside from the associated mortality, neurological * Fernanda Valerio [email protected] 1
University Division of Anaesthesia, Addenbrooke’s Hospital, University of Cambridge, Box 93, Hills Road, Cambridge CB2 0QQ, UK
Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
2
involvement of infectious disease can lead to prolonged hospital stay and significantly increase rehabilitation time and long-term care needs after discharge [135], posing a far-reaching socioeconomic burden. As the world deals with the Sars-CoV2 pandemic, reports of neurologic manifestations have increased. Understanding neurological complications of previous pandemics, and the pathophysiological mechanisms that underlie them, are fundamental to place the
Data Loading...
