[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]
Volume 24, Number 8—August 2018 / Synopsis
Case Series of Severe Neurologic Sequelae of Ebola Virus Disease during Epidemic, Sierra Leone
Patrick J. Howlett , Anna R. Walder, Durodami R. Lisk, Felicity Fitzgerald, Stephen Sevalie, Marta Lado, Abdul N’jai, Colin S. Brown, Foday Sahr, Foday Sesay, Jonathon M. Read, Paul J. Steptoe, Nicholas A.V. Beare, Reena Dwivedi, Marylou Solbrig, Gibrilla F. Deen, Tom Solomon, Malcolm G. Semple, and Janet T. Scott
Author affiliations: King’s College London & King’s Health Partners, London, UK (P.J. Howlett, A.R. Walder, M. Lado, C.S. Brown); University of Sierra Leone, Freetown, Sierra Leone (D.R. Lisk, A. N’jai, G.F. Deen); University College London Great Ormond Street Institute of Child Health, London (F. Fitzgerald); Save the Children, United Kingdom and Sierra Leone, London (F. Fitzgerald); University of Nairobi, Nairobi, Kenya (S. Sevalie); 34th Military Hospital, Republic of Sierra Leone Joint Armed Forces Joint Medical Unit, Freetown (S. Sevalie, F. Sahr, F. Sesay); Lancaster University, Lancaster, UK (J.M. Read); University of Liverpool, Liverpool, UK (J.M. Read, P.J. Steptoe, N.A.V. Beare, M.G. Semple, J.T. Scott); Royal Liverpool University Hospital, Liverpool (N.A.V. Beare, R. Dwivedi); University of Manitoba, Winnipeg, Manitoba, Canada (M. Solbrig); Institute of Global Health, Walton Centre NHS Foundation Trust, Liverpool (T. Solomon)
We describe a case series of 35 Ebola virus disease (EVD) survivors during the epidemic in West Africa who had neurologic and accompanying psychiatric sequelae. Survivors meeting neurologic criteria were invited from a cohort of 361 EVD survivors to attend a preliminary clinic. Those whose severe neurologic features were documented in the preliminary clinic were referred for neurology specialist evaluation, ophthalmology examination, and psychiatric assessment. Of 35 survivors with neurologic sequelae, 13 had migraine headache, 2 stroke, 2 peripheral sensory neuropathy, and 2 peripheral nerve lesions. Of brain computed tomography scans of 17 patients, 3 showed cerebral and/or cerebellar atrophy and 2 confirmed strokes. Sixteen patients required mental health followup; psychiatric disorders were diagnosed in 5. The 10 patients who experienced greatest disability had co-existing physical and mental health conditions. EVD survivors may have ongoing central and peripheral nervous system disorders, including previously unrecognized migraine headaches and stroke.
Keywords: Ebola; Neurology; Psychiatry; Sierra Leone.