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Excerpt
West Nile Fever (WNF) is caused by a flavivirus closely related to the St. Louis encephalitis, dengue, and Japanese encephalitis viruses. This is a neurotrophic virus, capable of infecting motor neuron in the brainstem and spinal cord. The clinical presentation of WNF may vary from a mild self-limiting febrile illness to meningoencephalitis, usually in older people. Although rarely reported, acute anterior myelitis is a serious complication of this disease. WNF is well known in the oriental hemisphere. An outbreak of West Nile fever has been reported in New York, raising the alert at the Centers for Disease Control and Prevention and medical community in general. A 60-yr-old male developed encephalitis after contracting WNF. The patient was transferred to our institution for comprehensive rehabilitation. He presented with significant proximal, asymmetrical muscle weakness. Anterior horn cell disease was confirmed by electromyography. Neurobehavioral Cognitive Status Examination was consistent with decreased concentration, attention, and short-term recall. This seems to be the third case of acute anterior myelitis associated with WNF reported in the literature. This case report also emphasizes the characterization of cognitive deficits associated with West Nile encephalitis and related rehabilitation issues.
