BMJ Case Reports 2011; doi:10.1136/bcr.12.2010.3672
  • Unusual presentation of more common disease/injury

Subdural haematoma and axonal polyneuropathy complicating dengue fever

  1. Nirdesh Jain
  1. Department of Medicine, CSM Medical University, Lucknow, India
  1. Correspondence to Dr Madhukar Mittal, mittalspace{at}


The authors report a case of dengue fever presenting with aseptic meningoencephalitis and developing subdural haematoma and pure motor quadriparesis due to axonal polyneuropathy. This 27-year-old female patient presented to us during the latter part of the dengue epidemic in India in 2010. She had mild thrombocytopaenia and subtle signs of capillary leak. Dengue-specific IgM antibody was positive. She presented initially with recurrent seizures. Initial CT scan of brain was normal with cerebrospinal fluid showing albuminocytologic dissociation. After 6 days, the patient developed quadriparesis with areflexia. MRI showed bilateral subdural haematoma with no evidence of spinal nerve root compression. The nerve conduction study showed evidence of axonal neuropathy. The patient’s quadriparesis improved such that she was able to walk with support after 4 weeks with conservative management. This case report highlights a possible association between dengue and motor axonal neuropathy subtype of Guillain–Barré syndrome.


  • Competing interests None.

  • Patient consent Obtained.

Register for free content

The full text of all Editor's Choice articles and summaries of every article are free without registration

The full text of Images in ... articles are free to registered users

Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource

Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog

Navigate This Article