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Neuropathological findings in West Nile virus encephalitis: A case report
Author(s) -
Agamanolis Dimitri P.,
Leslie Michael J.,
Caveny Elizabeth A.,
Guarner Jeannette,
Shieh WunJu,
Zaki Sherif R.
Publication year - 2003
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.10731
Subject(s) - bulbar palsy , encephalitis , medicine , pathology , spinal cord , west nile virus , brainstem , virus , virology , pediatrics , psychiatry
A 67‐year‐old woman had fever, myalgias, progressive weakness, and respiratory insufficiency. In 9 days, flaccid areflexic quadriparesis and bulbar palsy developed. She died 26 days after the onset of her illness. Serum and cerebrospinal fluid serology were positive for West Nile virus. Neuropathological study showed changes consistent with a viral encephalomyelitis, similar to poliomyelitis. The brainstem showed neuronal loss and multiple foci of necrosis. The spinal cord showed severe loss of anterior and posterior horn neurons. Immunohistochemistry identified West Nile virus antigens in the brainstem and spinal cord. Paralysis, in West Nile virus encephalitis, is caused by destruction of motor neurons. Ann Neurol 2003;54:547‐551