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REVIEW article

Front. Microbiol.

Sec. Virology

Volume 16 - 2025 | doi: 10.3389/fmicb.2025.1536955

This article is part of the Research TopicArbovirus Research: Surveillance, Impact, and ManagementView all articles

Pathophysiology and Clinical Implications of Dengue-Associated Neurological Disorders

Provisionally accepted
Ramtin  NaderianRamtin Naderian1,2Elham  ParaandavajiElham Paraandavaji3Amir  Hossein MaddahAmir Hossein Maddah1Saeedeh  KeshavarziSaeedeh Keshavarzi1Anoosha  HabibianAnoosha Habibian1Rayan  NaderianRayan Naderian4Seyed  Mohammad HosseiniSeyed Mohammad Hosseini5Valentyn  OksenychValentyn Oksenych6,7,8*Majid  EslamiMajid Eslami9*
  • 1Universal Scientific Education and Research Network (USERN), Semnan, Iran, Semnan, Iran
  • 2Nervous System Stem Cells Research Center, Semnan University of Medical Sciences, Semnan, Semnan, Iran
  • 3Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Tehran, Iran
  • 4Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
  • 5Department of Pediatrics, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran, Semnan, Iran
  • 6University of Bergen, 5020 Bergen, Norway, Bergen, Norway
  • 7Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), 7028 Trondheim, Norway, Trondheim, Norway
  • 8Department of Biosciences and Nutrition, Karolinska Institutet, 14183 Huddinge, Sweden, Huddinge, Sweden
  • 9Department of bacteriology and Virology, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran, Semnan, Iran

The final, formatted version of the article will be published soon.

Dengue virus (DENV), a mosquito-borne Flavivirus, represents a growing global health challenge, particularly in tropical and subtropical regions. The 2009 WHO classification system for dengue categorizes infections into dengue without warning signs, dengue with warning signs, and severe dengue. This framework highlights the diverse clinical presentations and supports more efficient triage and management of cases. The neurological effects of DENV infection, which include direct neuroinvasion, systemic problems, and immune-mediated sequelae, are a less well-studied but nevertheless important consequence. Guillain-Barré syndrome, acute disseminated encephalomyelitis, myelitis, meningitis, and encephalitis are important neurological symptoms. The dengue classification system improves clinical management by dividing cases into dengue without warning signs, dengue with warning signs, and severe dengue. Mild cases show fever with symptoms like headache and rash, while warning signs include abdominal pain, persistent vomiting, bleeding, and lab changes indicating higher risk. Severe dengue is characterized by critical complications such as shock, severe bleeding, or organ failure. Improved diagnostics aid early detection, and new treatments targeting viral replication and inflammation are being explored alongside supportive care. Although there are still challenges in reaching the ideal vaccination coverage, the introduction of potent vaccines like Dengvaxia and Qdenga provide an achievable option for prevention. Thorough study into DENV's neurological effects and treatment options is essential as the virus's geographic range is increased by climate change and international travel. Reducing the worldwide burden of dengue-related neurological complications requires addressing the intricate interactions between virological, immunological, and environmental variables.

Keywords: Dengue, denv, Encephalitis, Neuroinvasion, Neurological Disorder

Received: 29 Nov 2024; Accepted: 31 Aug 2025.

Copyright: © 2025 Naderian, Paraandavaji, Maddah, Keshavarzi, Habibian, Naderian, Hosseini, Oksenych and Eslami. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Valentyn Oksenych, University of Bergen, 5020 Bergen, Norway, Bergen, Norway
Majid Eslami, Department of bacteriology and Virology, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran, Semnan, Iran

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