Guillain-Barre syndrome (GBS) and other neurologic disorders are strongly associated with, and suspected to be caused by, Zika virus infection but the link is unestablished and studies are ongoing, including to elucidate a possible mechanism.[9]Dos Santos T, Rodriguez A, Almiron M, et al. Zika virus and the Guillain-Barré syndrome - case series from seven countries. N Engl J Med.2016 Oct 20;375(16):1598-601.
http://www.nejm.org/doi/full/10.1056/NEJMc1609015?query=featured_zika
http://www.ncbi.nlm.nih.gov/pubmed/27579558?tool=bestpractice.com
[10]Parra B, Lizarazo J, Jiménez-Arango JA, et al. Guillain-Barré syndrome associated with Zika virus infection in Colombia. N Engl J Med. 2016 Oct 20;375(16):1513-23.
http://www.nejm.org/doi/full/10.1056/NEJMoa1605564#t=article
http://www.ncbi.nlm.nih.gov/pubmed/27705091?tool=bestpractice.com
[11]Frontera JA, da Silva IR. Zika getting on your nerves? The association with the Guillain-Barré syndrome. N Engl J Med. 2016 Oct 20;375(16):1581-82.
http://www.nejm.org/doi/full/10.1056/NEJMe1611840
http://www.ncbi.nlm.nih.gov/pubmed/27705077?tool=bestpractice.com
[12]Leis AA, Stokic DS. Zika virus and Guillain–Barre syndrome: is there sufficient evidence for causality? Front Neurol. 2016 Sep 30;7:170.
http://journal.frontiersin.org/article/10.3389/fneur.2016.00170/full
http://www.ncbi.nlm.nih.gov/pubmed/27746763?tool=bestpractice.com
Current evidence estimates the incidence of GBS to be 24 cases per 100,000 persons infected with Zika.[44]Uncini A, Shahrizaila N, Kuwabara S. Zika virus infection and Guillain-Barré syndrome: a review focused on clinical and electrophysiological subtypes. J Neurol Neurosurg Psychiatry. 2017 Mar;88(3):266-71.
http://www.ncbi.nlm.nih.gov/pubmed/27799296?tool=bestpractice.com
Cases of acute myelitis, meningoencephalitis, and acute disseminated encephalomyelitis have been reported in patients with Zika virus infection.[225]American Academy of Neurology. Zika virus may now be tied to another brain disease. April 2016 [internet publication].
https://www.aan.com/PressRoom/Home/PressRelease/1451
[226]Barcellos C, Xavier DR, Pavão AL, et al. Increased hospitalizations for neuropathies as indicators of Zika virus infection, according to health information system data, Brazil. Emerg Infect Dis. 2016 Nov;22(11):1894-9.
http://wwwnc.cdc.gov/eid/article/22/11/16-0901_article
http://www.ncbi.nlm.nih.gov/pubmed/27603576?tool=bestpractice.com
[227]Soares CN, Brasil P, Carrera RM, et al. Fatal encephalitis associated with Zika virus infection in an adult. J Clin Virol. 2016 Oct;83:63-5.
http://www.ncbi.nlm.nih.gov/pubmed/27598870?tool=bestpractice.com
[228]Niemeyer B, Niemeyer R, Borges R, et al. Acute disseminated encephalomyelitis following Zika virus infection. Eur Neurol. 2017;77(1-2):45-6.
http://www.ncbi.nlm.nih.gov/pubmed/27894121?tool=bestpractice.com
A case of rapidly developing acute demyelinating polyneuropathy while the Zika virus was still present in the serum of the patient has been reported.[119]Siu R, Bukhari W, Todd A, et al. Acute Zika infection with concurrent onset of Guillain-Barré syndrome. Neurology. 2016 Jun;7(2):220.
http://www.neurology.org/content/early/2016/07/27/WNL.0000000000003038.long
http://www.ncbi.nlm.nih.gov/pubmed/27466468?tool=bestpractice.com
Acute sensory polyneuropathy has been reported in one patient during the active infectious phase.[229]Medina MT, England JD, Lorenzana I, et al. Zika virus associated with sensory polyneuropathy. J Neurol Sci. 2016 Oct 15;369:271-2.
http://www.jns-journal.com/article/S0022-510X(16)30535-4/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/27653905?tool=bestpractice.com
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