Neurologic Manifestations and Outcome of West Nile Virus Infection
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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Movement disorders persist for months to years in WNE patients.
“Movement disorders persist for months to years [83, 87–91].”
From Cognitive decline following acute viral infections: literature review and projections for post-COVID-19 (2022) · cites this paper as [83]
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- Authors
- Sejvar, J. J.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Corresponding author
- Sejvar, James J.
- ORCID
- Sejvar, James J.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2003-07-23
- Volume
- 290
- Issue
- 4
- Pages
- 511
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2104957765
- Cited by
- 648
- References
- 29
- Citations by year
- 2026: 19 · 2025: 28 · 2024: 28 · 2023: 27 · 2022: 12 · 2021: 22 · 2020: 22 · 2019: 33 · 2018: 26 · 2017: 16 · 2016: 21 · 2015: 22 · 2014: 34 · 2013: 35 · 2012: 31
- FWCI
- 45.37
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Mosquito-borne diseases and control
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Vectors
- Keywords
- West Nile virus, neurologic manifestations, encephalitis, meningitis, acute flaccid paralysis, parkinsonism, tremor, myoclonus, movement disorders, long-term outcomes, persistent fatigue
- MeSH terms
- Activities of Daily Living, Antibodies, Viral, Central Nervous System, Electroencephalography, Electromyography, Hospitalization, Humans, Magnetic Resonance Imaging, Meningitis, Viral, Movement Disorders, Muscle Hypotonia, Myoclonus, Neurologic Examination, Neuropsychological Tests, Paralysis, Tomography, X-Ray Computed, West Nile Fever, West Nile virus, Glasgow Coma Scale, Disease Progression, Encephalitis, Viral
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