Image studies in Zika Virus neurological complications (P5.149)

Objective: To report neuroimaging findings in adult patients with neurological complications associated with ZIKV infection. Background: Zika virus (ZIKV) infection has been suggested to trigger severe neurological complications in adults, such as Guillain-Barre syndrome(GBS), radiculomyelitis, and meningoencephalitis. Design/Methods: We conducted a review of MRI findings in patients previously diagnosed with neurological syndromes associated to ZIKV infection. Results: Case 1: 35 y/o male (Encephalitis, GBS and myelitis). Post-contrast MRI showed enhancement in the cauda equina nerve roots on T1. T2 showed bilateral hyperintensity in cerebellar peduncles and corticospinal tracts. Case 2: 48 y/o female (Encephalitis). FLAIR showed diffuse hyperintensity in the brainstem, pons and cerebral peduncle. T2-MRI showed hyperintensity in the middle cerebellar peduncles and corticospinal tracts. Case 3: 52 y/o male (Encephalitis and myelitis). T2-MRI showed hyperintense lesions in lateral columns of the cervical spine and anterior portion of the medulla. The brain stem, middle cerebellar peduncles and corticospinal tracts are diffusively involved. Case 4: 48 y/o female (Encephalitis and myelitis). T2-MRI showed cerebellar peduncles hyperintensity. STIR showed hyperintense lesion in dorsal spine. Case 5: 35 y/o female (GBS). Conus medullaris and cauda equina nerve roots appear normal on T2-MRI. Post-contrast T1 enhancement in conus medullaris and cauda equina nerve roots. Case 6: 38 y/o female (Myelitis). Spine MRI hyperintense ill-defined lesions are seen on T2, in the cervicothoracic and middle thoracic spinal cord causing a mildly expansion of the cord. The lesions demonstrate contrast enhancement on T1. Conclusions: Besides the previous extensively described congenital abnormalities, ZIKV may be associated with a substantial increase in the incidence of a broad spectrum of life-threatening neurological syndromes in adults. Unfortunately, there are no specific neuroimaging findings that can be related to this viral infection. In addition, some abnormalities that are observed are very similar to those seen in other flavivirus infections. Study Supported by: NA Disclosure: Dr. Macedo has nothing to disclose. Dr. Dantas Pagliarini has nothing to disclose. Dr. Ferreira has nothing to disclose. Dr. Passos dos Santos has nothing to disclose. Dr. Andorinho has nothing to disclose. Dr. Davidovich has nothing to disclose. Dr. Da Silva has nothing to disclose. Dr. Hygino has nothing to disclose. Dr. Pupe has nothing to disclose. Dr. Nascimento has nothing to disclose.