West Nile virus (WNV)
West Nile virus (WNV) is a neurotropic virus that produces damage of varying severity and anatomic predilection. When the reactive inflammatory processes are restricted to the meninges, an aseptic meningitis with headache as the chief manifestation results. With additional brain parenchymal involvement, altered level of consciousness accompanies the headache and reflects the associated meningoencephalitis. Lancinating pains and focal areflexic weakness denote a myelitis, with inflammation of the spinal cord.
West Nile encephalitis (WNE) has become endemic in Canada since 1999 when it crossed over from the United States. The clinical spectrum of WNE includes aseptic meningitis, meningoencephalitis, or encephalitis with or without flaccid paralysis. Patients with WNE may present with features of both encephalitis and aseptic meningitis (meningoencephalitis). Most patients are febrile or have low-grade fevers.
West Nile virusis sneaky and can be stealth-like. It's hard to even know you have it. Most infected people do not have symptoms. Some think they have the flu or a cold. Most infections are asymptomatic and less than 1% of those infected develop severe illness.
WNV may cause encephalitis, aseptic meningitis, or atypical Guillain-Barré syndrome (GBS) in humans. GBS can also mimic brain death.
Guillain-Barre-like syndrome associated with West Nile virus (WNV) infection is very much similar to the classic Guillain-Barre syndrome. The literature describes severe brainstem disease with loss of brainstem reflexes, labile vital signs and features of "locked-in syndrome", often associated with mixed axonal degenerating and demyelinating processes in both GBS and WNV.
West Nile viral encephalitis mimicking hepatic encephalopathy is reported in
Heart & lung : the journal of critical care 2005;34(1):72-5. Other mimics of encephalopathy include meningitis, and encephalitis. The mildest form of hepatic encephalopathy is difficult to detect clinically, but may be demonstrated on neuropsychological testing.
WNV encephalitis mimicking CNS metastases from small cell lung cancer is reported in the American Journal of Medicine, Volume 115, Issue 7, Pages 594 – 595.
West Nile virus(WNV) can cause severe, potentially fatal neurological illnesses, which include encephalitis, meningitis, and Guillain Barre syndrome.
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