(3) Some patients "developed neurological symptoms during or immediately after the [ZIKV] infection, suggesting a parainfectious
rather than postinfectious pattern that is typically seen in GBS", as noted in a recent review.
Initial differential for this clinical presentation was broad including insomnia secondary to pain from corneal abrasion or other unidentified traumatic or infectious source, traumatic brain injury, thyrotoxicosis, developmental disorder with regression, encephalopathy due to acute intoxication, acute psychosis, postinfectious or parainfectious
encephalitis, and autoimmune encephalopathy.
(16) Hyperintense signal in frontal and periventricular white matter on T2 weighted images in MRI scan may signify demyelenation or edema and necrosis secondary to some ischemic insult which in turn may occur due to some acute viral infection or parainfectious
acute demyelenating encephalopathy.
Recurrent parainfectious rhabdomyolysis may be an integral part of the CCFDN phenotype, reported in an increasing number of patients [2, 4-6].
Voudris et al., "Congenital cataracts facial dysmorphism neuropathy (CCFDN) syndrome: a rare cause of parainfectious rhabdomyolysis," European Journal of Pediatrics, vol.
Muhlau, "The clinical spectrum and immunobiology of parainfectious
neuromyelitis optica (Devic) syndromes," Journal of Autoimmunity, vol.
Ihanamaki et al16 reported a case of parainfectious
bilateral optic neuritis associated with echoviral meningitis in an adult patient.
However, no abnormalities appeared in the cytochemical or microbiological analysis of the CSF nor in the computed tomography (CT) scan; the MRI showed moderate cortical and cerebellar atrophy, suggesting a parainfectious
* Infectious or parainfectious
myoclonus, such as new-variant Creutzfeldt-Jacob disease (nvCJD); subacute sclerosing panencephalitis (SSPE); viral encephalitis; and streptococcal infections;