WNE, West Nile Encephalitis
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- It is a viral miasm
- In 80%, it show no symptoms and mostly recover completely, though Fatigue / Weakness may last for Weeks / Months.
- Symptoms may range from fever to paralysis and meningitis.
- Sever infection can rarely cause permanent brain damage.
- The most common neuromuscular manifestation is a poliomyelitis syndrome with or without brain-stem involvement (Respiratory failure)
- Significant neurological deficits are [1]
- 49% Weakness
- 35% Tremor
- 16% Cranial neuropathy
| Entities | |||
|---|---|---|---|
| Poliomyelitis [2] |
|
GBS [2] | |
| Encephalitis |
|
||
| Myositis | |||
| Polyradiculitis | Brachial plexopathy [5] | ||
|
Rapid pulse, Flushed Face, Coldness of feet) | ||
- Parkinsonism
- Meningitis: Headache; retro-orbital
- Optic neuritis
- Pharyngitis: Rawness, Sore throat, Cervical lymphadenopathy
- Myocarditis: Palpitation
- Splenomegaly: Leukopenia
- Hepatitis: Hepatomegaly, Nausea, Vomiting, Loss of appetite, and Diarrhea
- Pancreatitis: Diarrhea
- Eruptions: maculopapular, pale roseolar
- Hyponatremia
- Lying in bed agg. Night agg
- Eye Pain. Injected
WNND
- West Nile Neuroinvasive Disease occurs in less than 1% of cases, resulting in meningitis, encephalitis, meningoencephalitis or a poliomyelitis-like syndrome.
- Often there is normal neuroimaging, although abnormalities including basal ganglia, thalamus, cerebellum, and brain-stem have been reported
- Muscular weakness + Lower motor neuron symptoms, Flaccid paralysis, + Hyporeflexia +No sensory abnormalities.[7]
WNP
- West Nile Poliomyelitis is an acute flaccid paralysis syndrome associated with WNV
- It is less common than WNM or WNE.
- It is generally characterized by the acute onset of Asymmetric limb weakness or paralysis in the absence of sensory loss.
- Pain sometimes precedes the paralysis. The paralysis can occur in the absence of fever, headache, or other common symptoms associated with WNV infection.
- Involvement of respiratory muscles, leading to acute respiratory failure, sometimes occurs.
- West-Nile reversible paralysis, Like WNP, the weakness or paralysis is asymmetric. Reported cases have been noted to have an initial preservation of deep tendon reflexes, which is not expected for a pure anterior horn involvement.
- Disconnect of upper motor neuron influences on the anterior horn cells possibly by myelitis or glutamate excitotoxicity have been suggested as mechanisms.[7]
- Typical WNE paralysis is characterized by muscle weakness, decreased tone, and loss of deep tendon reflexes attributed to destruction of anterior horn cells.[8]
Disease
Remedies
- ↑ Hart, J., Tillman, G., Kraut, M.A. et al. West Nile virus neuroinvasive disease: neurological manifestations and prospective longitudinal outcomes. BMC Infect Dis 14, 248 (2014). https://doi.org/10.1186/1471-2334-14-248
- ↑ 2.0 2.1 A Wolf in Sheep’s Clothing: West Nile Virus presenting as Guillain Barre Variant (P11-9.005) Subhan Tabba, Asif Kabani Neurology May 2022, 98 (18 Supplement) 3438;
- ↑ https://www.encephalitis.info/
- ↑ Paul J. Carson, Patrick Konewko, Kimberly S. Wold, Paul Mariani, Sunil Goli, Paula Bergloff, Ross D. Crosby, Long-Term Clinical and Neuropsychological Outcomes of West Nile Virus Infection, Clinical Infectious Diseases, Volume 43, Issue 6, 15 September 2006, Pages 723–730,
- ↑ Madden K. West Nile virus infection and its neurological manifestations. Clin Med Res. 2003 Apr;1(2):145-50. doi: 10.3121/cmr.1.2.145. PMID: 15931302; PMCID: PMC1069038.
- ↑ Budhram A, Sharma M, Shettar B, Hosseini-Moghaddam SM, Khaw AV. Sensory and autonomic involvement in West Nile virus-associated acute flaccid paralysis. Neurol Clin Pract. 2017 Oct;7(5):394-397. doi: 10.1212/CPJ.0000000000000373. PMID: 29620087; PMCID: PMC5874468.
- ↑ 7.0 7.1 Wikipedia
- ↑ Mojumder DK, Agosto M, Wilms H, Kim J. Is initial preservation of deep tendon reflexes in West Nile Virus paralysis a good prognostic sign? Neurol Asia. 2014 Mar;19(1):93-97. PMID: 25400704; PMCID: PMC4229851.
- ↑ REVIEW article Front. Neurol., 21 March 2012 Sec. Neuromuscular Disorders and Peripheral Neuropathies https://doi.org/10.3389/fneur.2012.00037