As the Zika virus has spread across the Americas these past few months, there has been more and more evidence that its greatest dangers are neurological. It’s been linked to the birth defect microcephaly, and the autoimmune nervous disorder Guillain-Barré pretty much from the beginning of the outbreak, but scientists are starting to see connections to other neurological conditions as well.

But this confirmation is hardly the end of Zika’s neurological mysteries. There have been recent case reports of people exposed to the virus who’ve come down with different kinds of infections of the brain and spinal cord. In Guadeloupe, there was a case of acute myelitis (an inflammation of the spinal cord) in a 15-year-old girl; there was a French case study of a man who came down with meningoencephalitis (inflammation of the brain and its outer membranes); and new research out of Recife, Brazil, presented at the American Academy of Neurology annual meeting, has found two people who, after presenting with symptoms consistent with Zika or another flavivirus, came down with acute disseminated encephalomyelitis (ADEM). ADEM is a “brief but widespread attack of inflammation in the brain and spinal cord,” according to the National Institutes of Health.

In the Recife sample, there were six patients who showed neurological symptoms (post-flavivirus symptoms)—the two ADEM cases, and four Guillain-Barré cases. Though both Guillain-Barré and ADEM are typically temporary conditions, in this study, five of the patients had “sustained motor dysfunction” after they were discharged, one had vision problems, and one had cognitive decline. ADEM, myelitis, and Guillain-Barré can all damage myelin, the protective sheath around nerve cells, which could lead to long-term consequences for nerve function.

All of this suggests that the Zika virus may target nerve cells in particular. (A previous study also found that Zika proliferates in neural stem cells, which may be how it causes microcephaly.) That may be why all these neurological conditions are occurring in association with Zika. But it’s not clear whether these kind of complications were always a feature of Zika, or if they’re new, Reuters reports.