Parkinsonism and neurological manifestations of influenza throughout the 20th and 21st centuries

Purpose Given the recent paper by Jang et al on A Highly Pathogenic H5N1 Influenza Virus which reported a novel animal model of parkinsonism we aimed to perform a complete historical review of the 20th and 21st century literature on parkinsonism and neurological manifestations of influenza Scope There were at least twelve major flu pandemics reported in the literature in the 20th and 21st century Neurological manifestations most prevalent during the pandemics Included delirium encephalitis ocular abnormalities amyotrophy myelopathy radiculopathy ataxia and seizures Very little parkinsonism was reported with the exception of the 1917 cases originally described by von Economo Conclusions To date there have been surprisingly few cases of neurological issues inclusive of parkinsonism associated with influenza pandemics Given the recent animal model of H5N1 influenza associated parkinsonism the medical establishment should be prepared to evaluate for the re-emergence of parkinsonism during future outbreaks (C) 2010 Elsevier Ltd All rights reserved