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JAMA. 2003 Jul 23;290(4):511-5.

Neurologic manifestations and outcome of West Nile virus infection.

Author information

  • 1Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, and Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Ga 30333, USA. zea3@cdc.gov

Erratum in

  • JAMA. 2003 Sep 10;290(10):1318.

Abstract

CONTEXT:

The neurologic manifestations, laboratory findings, and outcome of patients with West Nile virus (WNV) infection have not been prospectively characterized.

OBJECTIVE:

To describe prospectively the clinical and laboratory features and long-term outcome of patients with neurologic manifestations of WNV infection.

DESIGN, SETTING, AND PARTICIPANTS:

From August 1 to September 2, 2002, a community-based, prospective case series was conducted in St Tammany Parish, La. Standardized clinical data were collected on patients with suspected WNV infection. Confirmed WNV-seropositive patients were reassessed at 8 months.

MAIN OUTCOME MEASURES:

Clinical, neurologic, and laboratory features at initial presentation, and long-term neurologic outcome.

RESULTS:

Sixteen (37%) of 39 suspected cases had antibodies against WNV; 5 had meningitis, 8 had encephalitis, and 3 had poliomyelitis-like acute flaccid paralysis. Movement disorders, including tremor (15 [94%]), myoclonus (5 [31%]), and parkinsonism (11 [69%]), were common among WNV-seropositive patients. One patient died. At 8-month follow-up, fatigue, headache, and myalgias were persistent symptoms; gait and movement disorders persisted in 6 patients. Patients with WNV meningitis or encephalitis had favorable outcomes, although patients with acute flaccid paralysis did not recover limb strength.

CONCLUSIONS:

Movement disorders, including tremor, myoclonus, and parkinsonism, may be present during acute illness with WNV infection. Some patients with WNV infection and meningitis or encephalitis ultimately may have good long-term outcome, although an irreversible poliomyelitis-like syndrome may result.

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PMID:
12876094
[PubMed - indexed for MEDLINE]
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