Neuromuscular manifestations of human West Nile virus infection
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Physicians in areas with active West Nile virus (WNV) transmission should be aware that WNV infection can present as a polio-like syndrome and that the spectrum of neuromuscular signs and symptoms may range from acute flaccid paralysis in the absence of fever or meningoencephalitis to subjective weakness and disabling fatigue. This awareness will help to avoid less tenable diagnoses and the morbidity associated with inappropriate treatment. Although anterior horns are the major site of spinal cord pathology, inflammatory changes also may involve spinal sympathetic neurons and ganglia, providing an explanation for the autonomic instability seen in some patients with WNV infection. However, the role that autonomic dysfunction plays in the morbidity and mortality of human WNV infection has to be elucidated. Another unresolved issue with important neuromuscular implications is whether WNV infection may lead to autoimmune disease. Support for this contention arises from reports of WNV patients presenting with various neuromuscular diseases that have a presumed autoimmune mechanism, including Guillain-Barré syndrome, other demyelinating neuropathies, myasthenia gravis, brachial plexopathies, and stiff-person syndrome. Although there is no specific treatment or vaccine currently approved for WNV infection in humans, and the standard is supportive care only, several drugs that can alter the cascade of immunobiochemical events leading to neuronal death may be potentially useful. Among these agents, minocycline (a semisynthetic derivative of tetracycline), interferon alpha, and high-dose corticosteroids are candidate therapies, although human experience is limited. In addition, passive immunization with intravenous immune globulin containing WNV-specific antibodies seems promising, based on anecdotal human reports.
- Nash D, Mostashari F, Fine A, et al.: The outbreak of West Nile virus infection in the New York City area in 1999. N Engl J Med 2001, 344:1807–1814. CrossRef
- Petersen LR, Marfin AA: West Nile virus: a primer for the clinician. Ann Intern Med 2002, 137:173–179.
- Tyler KL: West Nile virus infection in the United States. Arch Neurol 2004, 61:1190–1195. This is a recent, concise neurologic review of WNV infection. CrossRef
- Asnis DS, Conetta R, Teixeira AA, et al.: The West Nile virus outbreak of 1999 in New York City: the Flushing Hospital experience. Clin Infect Dis 2000, 30:413–418. CrossRef
- Sampson BA, Ambrosi C, Charlot A, et al.: The pathology of human West Nile virus infection. Hum Pathol 2000, 31:527–531. CrossRef
- Centers for Disease Control and Prevention: Acute flaccid paralysis syndrome associated with West Nile virus infection-Mississippi and Louisiana, July–August 2002. MMWR 2002, 51:825–828.
- Glass JD, Samuels O, Rich MM: Poliomyelitis due to West Nile virus. N Engl J Med 2002, 347:1280–1281. CrossRef
- Leis AA, Stokic DS, Polk JL, et al.: A poliomyelitis-like syndrome from West Nile virus infection. N Engl J Med 2002, 347:1279–1280. CrossRef
- Li J, Loeb JA, Shy ME, et al.: Asymmetric flaccid paralysis: A neuromuscular presentation of West Nile virus infection. Ann Neurol 2003, 53:703–710. This case series emphasizes the neuromuscular aspects of WNV infection. CrossRef
- Al-Shekhlee A, Katirji B: Electrodiagnostic features of acute paralytic poliomyelitis associated with West Nile virus infection. Muscle Nerve 2004, 29:376–380. CrossRef
- Kelly TW, Prayson RA, Isada CM: Spinal cord pathology in West Nile virus infection. N Engl J Med 2003, 348:564–566. CrossRef
- Leis AA, Fratkin J, Stokic DS, et al.: West Nile poliomyelitis. Lancet Infect Dis 2003, 3:9–10. CrossRef
- Fratkin JD, Leis AA, Stokic DS, et al.: Spinal cord neuropathology in human West Nile virus infection. Arch Pathol Lab Med 2004, 128:533–537. This autopsy series extends previous descriptions of spinal cord neuropathology, documents involvement of dorsal root and sympathetic ganglia, and discusses implications.
- Guarner J, Shieh WJ, Hunter S, et al.: Clinicopathologic study and laboratory diagnosis of cases with West Nile virus encephalomyelitis. Hum Pathol 2004, 35:983–990. CrossRef
- Doron SI, Dashe JF, Adelman LS, et al.: Histopathologically proven poliomyelitis with quadriplegia and loss of brainstem function due to West Nile infection. Clin Infect Dis 2003, 37:e74-e77. CrossRef
- Manuelidis EE: Neuropathology of experimental West Nile virus infection in monkeys. J Neuropathol Exp Neurol 1956, 15:448–460.
- Cantile C, Di Guardo G, Eleni C, Arispici M: Clinical and neuropathological features of West Nile virus equine encephalomyelitis in Italy. Equine Vet J 2000, 32:31–35. CrossRef
- Cantile C, Del Piero F, Di Guardo G, Arispici M: Pathologic and immunohistochemical findings in naturally occurring West Nile virus infection in horses. Vet Pathol 2001, 38:414–421. CrossRef
- Steele KE, Linn MJ, Schoepp RJ, et al.: Pathology of fatal West Nile virus infection in native and exotic birds during the 1999 outbreak in New York City, New York. Vet Pathol 2000, 37:208–224. CrossRef
- Leis AA, Stokic DS, Webb RM, et al.: Clinical spectrum of muscle weakness in human West Nile virus infection. Muscle Nerve 2003, 28:302–308. CrossRef
- Sejvar JJ, Leis AA, Stokic DS, et al.: Acute flaccid paralysis and West Nile virus infection. Emerg Infect Dis 2003, 9:788–793.
- Jeha LE, Sila CA, Lederman RJ, et al.: West Nile virus infection. A new acute paralytic illness. Neurology 2003, 61:55–59. This study defines the clinical, laboratory, electrodiagnostic, radiologic, and pathologic features of WNV infection.
- Pepperell C, Rau N, Krajden S, Kern R, et al.: West Nile virus infection in 2002: Morbidity and mortality among patients admitted to hospital in southcentral Ontario. CMAJ 2003, 168:1399–1405. This study documents the clinical features of WNV infection in hospitalized patients.
- Bouffard JP, Riudavets MA, Holman R, Rushing EJ: Neuropathology of the brain and spinal cord in human West Nile virus infection. Clin Neuropathol 2004, 23:59–61.
- Park M, Hui JS, Bartt RE: Acute anterior radiculitis associated with West Nile virus infection. J Neurol Neurosurg Psychiatry 2003, 74:823–825. CrossRef
- Ahmed S, Libman R, Wesson K, et al.: Guillain-Barre syndrome: An unusual presentation of West Nile virus infection. Neurology 2000, 55:144–146.
- Sejvar J, Bode A, Ewing D, et al.: The spectrum of West Nile virus-associated weakness. Neurology 2004, 62(suppl 5):A446.
- Xu MY, Talkad AV, Karbowska-Jankowska M, et al.: Guillain-Barre syndrome associated with West Nile virus infection. Neurology 2003, 60(suppl 1):A107.
- Almhanna K, Palanichamy N, Sharma M, et al.: Unilateral brachial plexopathy associated with West Nile virus meningoencephalitis. Clin Infect Dis 2003, 36:1629–1630. CrossRef
- Betensley AD, Jaffery SH, Collins H, et al.: Bilateral diaphragmatic paralysis and related respiratory complications in a patient with West Nile virus infection. Thorax 2004, 59:268–289. CrossRef
- Smith RD, Konoplev S, DeCourten-Myers G, Brown T: West Nile virus encephalitis with myositis and orchitis. Hum Pathol 2004, 35:254–258. CrossRef
- Hund E: Critical illness polyneuropathy. Curr Opin Neurol 2001, 4:649–653. CrossRef
- Lacomis D, Zochodne DW, Bird SJ: Critical illness myopathy. Muscle Nerve 2000, 23:1785–1788. CrossRef
- Hassin-Baer S, Kirson ED, Shulman L, et al.: Stiff-person syndrome following West Nile fever. Arch Neurol 2004, 61:938–941. CrossRef
- Argall KG, Armati PJ, King NJ, Douglas MW: The effects of West Nile virus on major histocompatibility complex class I and II molecule expression by Lewis rat Schwann cells in vitro. J Neuroimmol 1991, 35:273–284. CrossRef
- Bao S, King NJ, Dos Remedios CG: Flavivirus induces MHC antigen on human myoblasts: a model of autoimmune myositis? Muscle Nerve 1992, 15:1271–1277. CrossRef
- Kesson AM, Cheng Y, King NJ: Regulation of immune recognition molecules by flavivirus, West Nile. Viral Immunol 2002, 15:273–283. CrossRef
- Bruno RL, Cohen JM, Galski T, Frick NM: The neuroanatomy of post-polio fatigue. Arch Phys Med Rehabil 1994, 75:498–504.
- Campbell GL, Marfin AA, Lanciotti RS, Gubler DJ: West Nile virus. Lancet Infect Dis 2002, 2:519–529. CrossRef
- New York Department of Health: West Nile virus surveillance and control: an update for healthcare providers in New York City. City Health Information 2001, 20:1–7.
- Paul JR: A History of Poliomyelitis. New Haven: Yale University Press; 1971.
- Darman J, Backovic S, Dike S, et al.: Viral-induced spinal motor neuron death is non-cell-autonomous and involves glutamate excitotoxicity. J Neurosci 2004, 34:7566–7575. This study investigated the mechanisms underlying viral-induced spinal motor neuron death in rodents, and confirmed an excitotoxic mechanism. Therapeutic implications for WNV infection are discussed. CrossRef
- Jackson AC, Moench TR, Trapp BD, Griffin DE: Basis of neurovirulence in Sindbis virus encephalomyelitis of mice. Lab Invest 1988, 58:503–509.
- Havert MB, Schofield B, Griffin De, Irani DN: Activation of divergent neuronal cell death pathways in different target cell populations during neuroadapted Sindbis virus infection of mice. J Virol 2000, 4:5352–5356. CrossRef
- Morrey JD, Day CW, Julander JG, et al.: Effect of interferon-alpha and interferon-inducers on West Nile virus is mouse and hamster animal models. Antivir Chem Chemother 2004, 15:101–109.
- Sayao A, Patry D, Suchowersky O, et al.: A report of seven cases of West Nile virus neurological syndrome in Calgary, Alberta: Clinical presentations and treatment with interferon alpha-2B. Neurology 2004, 62:A404.
- Wang T, Scully E, Yin Z, et al.: IFN-gamma-producing gamma delta T cells help control murine West Nile virus infection. J Immunol 2003, 171:2524–2531.
- Pyrgos V, Younus F: High-dose steroids in the management of acute flaccid paralysis due to West Nile virus infection. Scand J Infect Dis 2004, 36:509–512. CrossRef
- Narayanaswami P, Edwards L, Hyde C, et al.: West Nile meningitis/encephalitis: Experience with corticosteroid therapy. Neurology 2004, 62:A404.
- Gea-Banacloche J, Johnson RT, Bagic A, et al.: West Nile virus: Pathogenesis and therapeutic options. NIH conference. Ann Intern Med 2004, 140:545–553.
- Ben-Nathan D, Lustig S, Tam G, et al.: Prophylactic and therapeutic efficacy of human intravenous immunoglobulin in treating West Nile virus infection in mice. J Infect Dis 2003, 188:5–12. CrossRef
- Hamdan A, Green P, Mendelson E, et al.: Possible benefit of intravenous immunoglobulin therapy in a lung transplant recipient with West Nile virus encephalitis. Transpl Infect Dis 2002, 4:160–162. CrossRef
- Agrawal AG, Peterson LR: Human immunoglobulin as a treatment for West Nile virus infection. J Infect Dis 2003, 188:1–4. CrossRef
- Haley M, Retter A, Fowler D, et al.: The role for intravenous immunoglobulin in the treatment of West Nile virus encephalitis. Clin Infect Dis 2003, 37:e88-e90. CrossRef
- Neuromuscular manifestations of human West Nile virus infection
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