Document Detail

Clinical spectrum of muscle weakness in human West Nile virus infection.
MedLine Citation:
PMID:  12929189     Owner:  NLM     Status:  MEDLINE    
Poliomyelitis has recently been identified as a cause of muscle weakness in patients with West Nile virus (WNV) infection. However, the clinical spectrum of WNV-associated weakness has not been described. We reviewed data on 13 patients with WNV infection. Patients with muscle weakness were classified into one of three distinct groups based on clinical features. Group 1 comprised five patients who developed acute flaccid paralysis, four with meningoencephalitis and one without fever or other signs of infection. Paralysis was asymmetric, and involved from one to four limbs in individual patients. Electrodiagnostic studies confirmed involvement of anterior horn cells or motor axons. Group 2 involved two patients without meningoencephalitis who developed severe but reversible muscle weakness that recovered completely within weeks. Muscle weakness involved both lower limbs in one patient and one upper limb in the other. Group 3 consisted of two patients who experienced subjective weakness and disabling fatigue, but had no objective muscle weakness on examination. In addition to the three distinct groups, two other patients developed exaggerated weakness in the distribution of preexisting lower motor neuron dysfunction. We conclude that the clinical spectrum of WNV-associated muscle weakness ranges from acute flaccid paralysis, with or without fever or meningoencephalitis, to disabling fatigue. Also, preexisting dysfunction may predispose anterior horn cells to additional injury from WNV. Awareness of this spectrum will help to avoid erroneous diagnoses and inappropriate treatment.
A Arturo Leis; Dobrivoje S Stokic; Risa M Webb; Sally A Slavinski; Jonathan Fratkin
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Muscle & nerve     Volume:  28     ISSN:  0148-639X     ISO Abbreviation:  Muscle Nerve     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-08-20     Completed Date:  2003-09-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803146     Medline TA:  Muscle Nerve     Country:  United States    
Other Details:
Languages:  eng     Pagination:  302-8     Citation Subset:  IM    
Center for Neuroscience and Neurological Recovery, Methodist Rehabilitation Center, 1350 East Woodrow Wilson, Suite 2, Jackson, Mississippi 39216, USA.
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MeSH Terms
Acute Disease
Immunoglobulin M / blood
Middle Aged
Motor Neurons / pathology,  virology
Muscle Weakness / physiopathology*,  virology*
Muscle, Skeletal / innervation,  physiopathology,  virology
Poliomyelitis / physiopathology*,  virology*
Quadriplegia / physiopathology,  virology
Retrospective Studies
Spinal Cord / pathology,  physiopathology,  virology
West Nile Fever / complications*,  physiopathology*
West Nile virus / immunology,  pathogenicity*
Reg. No./Substance:
0/Immunoglobulin M

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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