Journal article
Asymmetric flaccid paralysis: A neuromuscular presentation of West Nile virus infection
Annals of neurology, Vol.53(6), pp.703-710
2003
DOI: 10.1002/ana.10575
PMID: 12783415
Abstract
The neuromuscular aspects of West Nile virus (WNV) infection have not been characterized in detail. We have studied a group of six patients with proven WNV infection. All cases presented with acute, severe, asymmetric, or monolimb weakness, with minimal or no sensory disturbance after a mild flu-like prodrome. Four cases also had facial weakness. Three of our cases had no encephalitic signs or symptoms despite cerebrospinal fluid pleocytosis. Electrophysiological studies showed severe denervation in paralyzed limb muscles, suggesting either motor neuron or multiple ventral nerve root damage. This localization is supported further by the finding of abnormal signal intensity confined to the anterior horns on a lumbar spine magnetic resonance imaging. Muscle biopsies from three patients showed scattered necrotic fibers, implicating mild direct or indirect muscle damage from the WNV infection. In summary, we describe a group of patients with acute segmental flaccid paralysis with minimal or no encephalitic or sensory signs. We have localized the abnormality to either the spinal motor neurons or their ventral nerve roots. It will be important for physicians to consider WNV infection in patients with acute asymmetric paralysis with or without encephalitic symptoms.
Details
- Title: Subtitle
- Asymmetric flaccid paralysis: A neuromuscular presentation of West Nile virus infection
- Creators
- Jun Li - Department of Neurology, Wayne State University School of Medicine, Detroit, MI, United StatesJeffrey A LOEB - Department of Neurology, Wayne State University School of Medicine, Detroit, MI, United StatesMichael E SHY - Department of Neurology, Wayne State University School of Medicine, Detroit, MI, United StatesAashit K SHAH - Department of Neurology, Wayne State University School of Medicine, Detroit, MI, United StatesAlex C TSELIS - Department of Neurology, Wayne State University School of Medicine, Detroit, MI, United StatesWilliam J KUPSKI - Department of Pathology, Wayne State University School of Medicine, Detroit, MI, United StatesRichard A LEWIS - Department of Neurology, Wayne State University School of Medicine, Detroit, MI, United States
- Resource Type
- Journal article
- Publication Details
- Annals of neurology, Vol.53(6), pp.703-710
- Publisher
- Willey-Liss; Hoboken
- DOI
- 10.1002/ana.10575
- PMID
- 12783415
- ISSN
- 0364-5134
- eISSN
- 1531-8249
- Language
- English
- Date published
- 2003
- Academic Unit
- Neurology; Molecular Physiology and Biophysics; Stead Family Department of Pediatrics; Iowa Neuroscience Institute
- Record Identifier
- 9984013111702771
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