WNE, West Nile Encephalitis: Difference between revisions

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=== Clinic ===
=== kkkClinic ===
* 80% of WNV show no symptoms
* It is a [[Viral miasms|viral miasm]]
*Mostly they recover completely, though Fatigue / Weakness may last for Weeks / Months.
* In 80%, it show no symptoms and mostly recover completely, though Fatigue / Weakness may last for Weeks / Months.
*Symptoms may range from mild, such as fever, to severe, such as paralysis and meningitis.  
*Symptoms may range from fever to paralysis and [[meningitis]].
*Sever infection can rarely cause permanent brain damage.
*Sever infection can rarely cause permanent brain damage.
*The most common neuromuscular manifestation is a [[poliomyelitis syndrome]] with or without [[Brainstem|brain-stem]] involvement and respiratory failure.
*The most common neuromuscular manifestation is a poliomyelitis syndrome with or without [[Brainstem|brain-stem]] involvement (Respiratory failure)
*Significant neurological deficits are <ref>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). <nowiki>https://doi.org/10.1186/1471-2334-14-248</nowiki></ref>
**49% Weakness
**35% Tremor
**16% Cranial neuropathy




=== Entities ===
{| class="wikitable"
*Poliomyelitis <ref name=":0">A Wolf in Sheep’s Clothing: West Nile Virus presenting as Guillain Barre Variant (P11-9.005)
|+
!Entities
!
!
!
|-
|Poliomyelitis <ref name=":0">A Wolf in Sheep’s Clothing: West Nile Virus presenting as Guillain Barre Variant (P11-9.005)


Subhan Tabba, Asif Kabani
Subhan Tabba, Asif Kabani


Neurology May 2022, 98 (18 Supplement) 3438;</ref>/ [[GBS, Guillian Barre syndrome|GBS]] <ref name=":0" />/ [[LMN, Lower motor neuron entities|LMN]]: Asymmetrical [[Flaccid Paralysis miasms|flaccid Paralysis]] (Monoparesis, [[Hemiparesis miasms|Hemiparesis]], Quadriparesis)
Neurology May 2022, 98 (18 Supplement) 3438;</ref>
*Significant neurological deficit in 93% (49% Weakness, 35% Tremor and 16% Cranial neuropathy).<ref>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). <nowiki>https://doi.org/10.1186/1471-2334-14-248</nowiki></ref>
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*[[Encephalitis]]
* [[LMN, Lower Motor Neuron|LMN]]
**Mild confusion / Deep coma
* Asymmetrical [[Flaccid Paralysis miasms|flaccid Paralysis]] (Monoparesis, [[Hemiparesis miasms|Hemiparesis]], Quadriparesis)
**Behavioural changes (Like Hysteria)
|[[GBS, Guillian Barre syndrome|GBS]] <ref name=":0" />
**[[Seizure|Convulsions]] <ref>https://www.encephalitis.info/</ref>  
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**[[Depression remedies|Depression]] <ref>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,</ref>
|-
|[[Encephalitis]]
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*Mild confusion / Deep coma
*Behavioral changes (Like [[Hysteria remedies|Hysteria]])
*[[Seizure|Convulsions]] <ref>https://www.encephalitis.info/</ref>  
*[[Depression]] <ref>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,</ref>
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|Myositis 
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|[[Polyradiculitis]]
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|[[Brachial plexus neuropathy|Brachial plexopathy]] <ref name=":2">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.</ref>
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* Spinal sympathetic ganglianopathy (Autonomic instability) <ref>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.</ref>
|Rapid pulse, Flushed Face, Coldness of feet)
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* [[Parkinsonism]]
** [[Tremor]] (35%)
** Bradykinesia
** [[Rigidity]] / [[Spasm]]  / Stiffness
**[[Ataxia]] /Postural instability
* [[Meningitis]]: Headache; retro-orbital
* [[Optic neuritis]]


* Myositis <ref name=":1">REVIEW article


Front. Neurol., 21 March 2012


Sec. Neuromuscular Disorders and Peripheral Neuropathies
<nowiki>https://doi.org/10.3389/fneur.2012.00037</nowiki></ref>
* [[Polyradiculitis]] / [[Brachial plexus neuropathy|Brachial plexopathy]]  <ref name=":2">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.</ref>
*
* Spinal sympathetic ganglianopathy (Autonomic instability: Rapid pulse, Flushed Face, Coldness of feet) <ref>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.</ref>
* [[Parkinsonism]]
** [[Tremor miasms|Tremor]]
** [[Bradykinesia miasms|Bradykinesia]]
** [[Rigidity miasms|Rigidity]] / [[Spasm miasms|Spasm]]  / Stiffness
**[[Ataxia]] /Postural instability
* [[Meningitis]]: Headache; retro-orbital
* Eye Pain. Injected
* [[Optic neuritis]]
* [[Pharyngitis]]: Rawness, Sore throat, Cervical lymphadenopathy
* [[Pharyngitis]]: Rawness, Sore throat, Cervical lymphadenopathy
* [[Myocarditis]]: Palpitation  
* [[Myocarditis]]: Palpitation


* Splenomegaly: Leukopenia
* Splenomegaly: Leukopenia
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*Hyponatremia
*Hyponatremia
*Lying in bed agg. Night agg
*Lying in bed agg. Night agg
*Eye Pain. Injected




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* '''W'''est '''N'''ile '''N'''euroinvasive '''D'''isease occurs in less than 1% of cases, resulting in meningitis, encephalitis, [[Meningoencephalitis remedies|meningoencephalitis]] or a poliomyelitis-like syndrome.
* '''W'''est '''N'''ile '''N'''euroinvasive '''D'''isease occurs in less than 1% of cases, resulting in meningitis, encephalitis, [[Meningoencephalitis remedies|meningoencephalitis]] or a poliomyelitis-like syndrome.
* Often there is normal neuroimaging, although abnormalities including basal ganglia, thalamus, cerebellum, and brain-stem have been reported
* Often there is normal neuroimaging, although abnormalities including basal ganglia, thalamus, cerebellum, and brain-stem have been reported
* Muscular weakness + [[LMN, Lower motor neuron entities|Lower motor neuron symptoms]], Flaccid paralysis, + Hyporeflexia +No sensory abnormalities.<ref name=":3">Wikipedia</ref>
* Muscular weakness + [[LMN, Lower Motor Neuron|Lower motor neuron symptoms]], Flaccid paralysis, + Hyporeflexia +No sensory abnormalities.<ref name=":3">Wikipedia</ref>




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=== Disease ===


* [[Myasthenia gravis]]
* [[Stiff person syndrome|Stiff-person syndrome]] <ref name=":1">REVIEW article


Front. Neurol., 21 March 2012


Sec. Neuromuscular Disorders and Peripheral Neuropathies


 
<nowiki>https://doi.org/10.3389/fneur.2012.00037</nowiki></ref>
*
*[[Parkinson disease]]
 
=== Disease ===
 
* Myasthenia gravis
* [[Stiff person syndrome|Stiff-person syndrome]] <ref name=":1" />
*[[Parkinson remedies|Parkinson]] disease






=== Remedies ===
=== [[Homeopathic remedies|Remedies]] ===
#
#
# '''[[Iod, Iodium|IOD]], [[Merc, Mercurius Solubilis|MERC]].''' '''PHOS'''
# '''[[Iod, Iodium|IOD]], [[Merc, Mercurius Solubilis|MERC]].''' '''PHOS'''
# ''Bell,'' ''Caust.''  ''Cupr.'' ''Plb.'' ''Sil.'' ''Sulph.''
# Bell, Caust.  Cupr. Plb. Sil. Sulph.
# agar, aur. Calc con gels kali-c
# agar, aur. Calc con gels kali-c




<references />
<references />

Latest revision as of 22:51, 4 September 2023

kkkClinic

  • 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]
  • Spinal sympathetic ganglianopathy (Autonomic instability) [6]
 Rapid pulse, Flushed Face, Coldness of feet)


  • 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

  2. IOD, MERC. PHOS
  3. Bell, Caust.  Cupr. Plb. Sil. Sulph.
  4. agar, aur. Calc con gels kali-c


  1. ↑ 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. ↑ 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;
  3. ↑ https://www.encephalitis.info/
  4. ↑ 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,
  5. ↑ 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.
  6. ↑ 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. ↑ 7.0 7.1 Wikipedia
  8. ↑ 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.
  9. ↑ REVIEW article Front. Neurol., 21 March 2012 Sec. Neuromuscular Disorders and Peripheral Neuropathies https://doi.org/10.3389/fneur.2012.00037
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