Dengue is an arboviral infection seen in tropical countries. It presents as a febrile illness and thrombocytopenia. Neurologic complications of Dengue infection has an incidence of 0.5-20% in recent years. One of which, though rare, is neuritis, probably due to an autoimmune mediated pathology, that may present as craniopathies as seen in this patient.  

This a case of a 42 year old male admitted at a Tertiary Medical Center due to acute onset diplopia, decreased vision with bilateral Marcus Gunn pupils, left sided ptosis facial diplegia, and preceded and accompanied by a 2 day history of high grade fever. Patient was admitted and managed a case of Dengue infection with a positive Dengue NS1 Antigen test.

Neurologic examination revealed multiple cranial nerves affected (CN II, III, VI, VII) and no signs of meningeal irritation. On non-contrast cranial MRI with MRA and MRV showed lesion on the splenium of the Corpus Callosum and no other remarkable findings. Without treatment, noted rapid improvement of craniopathies as the Dengue infection resolved and with full resolution within seven days. We are reporting this patient to show a case of multiple craniopathies associated with dengue which resolved without treatment. Interestingly, patient had history transient ptosis and diplopia with fever and a diagnosed as a case of systemic viral infection a year prior to admission.

In review of case reports, other patients seen presented only with isolated craniopathies or with meningeal involvement. Some of which received steroid treatment of IV immunoglobulin. Our patient only presented with craniopathies with no meningeal involvement. He responded with supportive treatment with IV hyrdration and anti-pyretics. Its significance is that there is reversibility of craniopathies as the Dengue infection resolves and is self-limiting.