Ebola leaves persistent neurological effects

Long-term neurological disorders persisted in Ebola survivors, and some survivors were associated with mental health problems, the researchers said.

Thirty-five of 40 patients at a clinic in Sierra Leone had neurological or psychiatric symptoms – including 13 who suffered from migraines, two patients who were diagnosed with stroke, two with peripheral sensory neuropathy, and two with peripheral nerve damage, reported Patrick Howlett, MD, of the University of Liverpool in Liverpool, England, and colleagues

. In addition, 16 of 19 patients from a neurological and psychiatric clinic were referred for local monitoring in mental health and five responded to a generalized anxiety disorder or major depressive disorder, the authors wrote in Emerging Infectious Diseases

Following the 2014-2016 Ebola outbreak in West Africa, brain imaging has shown that the virus can invade the central nervous system (CNS). He said the study, with documented cases of cerebral atrophy, meningoencephalitis and ischemia. Previous studies have also revealed increased fatigue, decreased work capacity, sleep disturbances, depression, anxiety, and coping disorders among Ebola survivors

. Ebola have been inconclusive. In one study, 90% of the subjects reported headaches, but compared to the control population, 75% of whom reported headaches, the results were not significant

"We wanted to try to provide a platform for high quality critical care for survivors in a way that was in partnership with Sierra Leone, "Howlett says MedPage Today . "The evidence shows how we are able to provide the level of specialized care and high quality that these Ebola survivors deserve."

Howlett and his team observed a group of 334 Ebola survivors who attended the 34th Hospital Hospital (34MD) Ebola Survivors Clinic Freetown in Sierra Leone. They were 12 years of age or older and had complete clinical records. The median age of the group was 28 years and it included 161 patients. Of the 334 Ebola survivors observed, 50% reported headache, 9.9% a loss of appetite and 6.6% generalized weakness.

To be invited to the clinic, subjects had to report at least one major problem (focal weakness, deafness, depression, and anxiety) or two minor symptoms (headache, insomnia, and weakness), or be referred by the clinic staff. About one-third (n = 111) were eligible for the clinic and 40 attended. Patients were more likely to be invited to the clinic than male patients.

21 patients (95% CI: 36.1% – 68.4%) reported having sleep disorders, 12 (95% CI: 16.5% – 46.5%), and 11 (95% CI 14.6% -43.9%) with symptoms of anxiety. Two physicians evaluated the cohort for neurological and psychiatric symptoms. Of the 40 patients, 19 were defined as having severe neurological symptoms and were referred to a joint neurological and psychiatric clinic where they received a brain scan and retinal imaging. Of the 17 patients who underwent CT scans, three had atypical cerebral and / or cerebellar atrophy and two confirmed clinical evaluation of stroke,

Twelve patients described eye pain and eight partial vision loss . The report indicates that 17 continued to be treated by specialists in ophthalmology, where imaging showed that three survivors had retinal Ebola lesions. Other neurological symptoms in the group included three cases of tinnitus, two cases of tremors and one case of asymmetric atrophy of the lower limbs with weakness of unknown etiology, the states of the tinnitus. ;study. The authors also found that 10 participants reported "high levels of disability", as well as physical symptoms and mental health issues.

"Our case series … confirms that there are long-term neurologic sequelae in EVD survivors [Ebola virus disease]. A significant proportion of these patients have mental health problems and disabilities, "conclude the authors. "Often, these problems come together, and services need to look for and support patients with a high burden of disease. If we want to extend specialized services to EVD survivors and the general population, the only credible and sustainable option is is to significantly increase support for specialized training of doctors in the country. "

Due to a lack of national data on conditions such as headaches and strokes, the researchers stated that they could not determine the absolute representativeness of their findings. The team did not test suspected cases of myopathy, despite the fact that diabetic neuropathy, trapping neuropathy or slow-recovery critical illness polyneuropathy are potential causes. at the clinic were not included because of their inability, as were patients who had only one symptom to report.

2018-07-11T13: 30: 00-0400