New findings from the Prevail III trial revealed long-term neurological problems in most Ebola survivors 6 months after their initial infection.
“What prompted our research is that a number of physicians already in Liberia were looking at survivors because there were already known issues, particularly ophthalmologic issues,” Bridgette Jeanne Billioux, MD, a neurologist at the NIH’s National Institute of Neurological Disorders and Stroke, told Infectious Disease News. “As the physicians were beginning to look at survivors, they noticed that there seemed to be some neurological issues.”
Bridgette Jeanne Billioux
Billioux and a team of neurologists evaluated 82 Ebola survivors who were enrolled in Prevail III — a study of the natural history of Ebola. The mean age of the survivors was 35 years. Study results will be presented at the American Academy of Neurology annual meeting, April 15-21, in Vancouver, British Columbia.
According to Billioux, most of the survivors experienced some type of neurological abnormality.
“Some of them were pretty subtle,” she said, “but some were pretty striking.”
The most common ongoing problems were weakness, headaches, memory loss, depressed mood, muscle pain and abnormal eye movement. Two Ebola survivors were suicidal, and one experienced active hallucinations. One survivor, who was seen outside of the study, exhibited symptoms similar to Parkinson’s disease that emerged after becoming infected by Ebola, Billioux said.
Neurologists at the NIH plan to follow up with the cohort every 6 months for several years to see if these issues improve, worsen, persist, or if they are related to something other than Ebola. A controlled study will help to determine which findings are Ebola-specific and which are related to background issues in West Africa, Billioux said. Researchers also intend to conduct imaging studies and laboratory testing of cerebral spinal fluid from survivors.
Billioux advises physicians who see Ebola survivors to be aware of neurological symptoms, such as headaches, seizures, memory issues and weakness complaints, that may be treatable.
“Just because somebody had a really bad neurologic course during the acute disease doesn’t mean that they will have it [for a longer duration],” she said. “It may get better, but we still need to study that further. It is important for physicians to know because there may be things that can be done about any of these possible symptoms and signs that the survivor may be dealing with.” – by Taylor Groff
Disclosure: The researchers report no relevant financial disclosures.