Clinical and neuroradiologic features of 39 consecutive cases of West Nile Virus meningoencephalitis
Background: West Nile Virus (WNV) is a flavivirus WNV that has spread westwards across North America in recent years. It can cause a febrile illness and infection of the central nervous system, which is associated with poor outcome. Methods: We retrospectively studied the clinical and neuroradiologi...
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| Veröffentlicht in: | Journal of the neurological sciences 2004-05, Vol.220 (1), p.37-40 |
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| creator | Brilla, Roland Block, Margo Geremia, Glen Wichter, Melvin |
| description | Background: West Nile Virus (WNV) is a flavivirus WNV that has spread westwards across North America in recent years. It can cause a febrile illness and infection of the central nervous system, which is associated with poor outcome.
Methods: We retrospectively studied the clinical and neuroradiologic features of 39 consecutive patients admitted during summer of 2002 that had IgM in the cerebrospinal fluid positive for WNV.
Results: Fever, headache and altered mentation were predominant clinical features. Clinically significant involvement of lower motor neurons was seen in few cases. Magnetic resonance imaging (MRI) of the brain did not show changes attributable to meningitis or encephalitis except for one case of subcortical signal abnormalities. Unfavorable prognostic factors are old age, decreased level of alertness and elevated serum creatinine.
Conclusions: Encephalopathic presentations, with or without additional neurological focality, dominated this series. Fever and meningitic signs are often absent. Involvement of lower motor neurons was uncommon. Given the paucity of positive findings, the value of MRI to support the diagnosis of WNV-meningoencephalitis is limited. |
| doi_str_mv | 10.1016/j.jns.2004.01.013 |
| format | Article |
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Methods: We retrospectively studied the clinical and neuroradiologic features of 39 consecutive patients admitted during summer of 2002 that had IgM in the cerebrospinal fluid positive for WNV.
Results: Fever, headache and altered mentation were predominant clinical features. Clinically significant involvement of lower motor neurons was seen in few cases. Magnetic resonance imaging (MRI) of the brain did not show changes attributable to meningitis or encephalitis except for one case of subcortical signal abnormalities. Unfavorable prognostic factors are old age, decreased level of alertness and elevated serum creatinine.
Conclusions: Encephalopathic presentations, with or without additional neurological focality, dominated this series. Fever and meningitic signs are often absent. Involvement of lower motor neurons was uncommon. Given the paucity of positive findings, the value of MRI to support the diagnosis of WNV-meningoencephalitis is limited.</description><identifier>ISSN: 0022-510X</identifier><identifier>EISSN: 1878-5883</identifier><identifier>DOI: 10.1016/j.jns.2004.01.013</identifier><identifier>PMID: 15140603</identifier><identifier>CODEN: JNSCAG</identifier><language>eng</language><publisher>Shannon: Elsevier B.V</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Brain - pathology ; Brain - physiopathology ; Child ; Enzyme-Linked Immunosorbent Assay - methods ; Female ; Focal findings ; Humans ; Immunoglobulin M - metabolism ; Lower motor neuron involvement ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Male ; Medical sciences ; Meningoencephalitis ; Meningoencephalitis - cerebrospinal fluid ; Meningoencephalitis - diagnostic imaging ; Meningoencephalitis - physiopathology ; Meningoencephalitis - virology ; Middle Aged ; Neurology ; Prognostic factors ; Radionuclide Imaging ; Retrospective Studies ; West Nile Virus</subject><ispartof>Journal of the neurological sciences, 2004-05, Vol.220 (1), p.37-40</ispartof><rights>2004 Elsevier B.V.</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c379t-77543fa308dc7d374e86e44790155125118f900b05f946e70baabfcf0dda6bbf3</citedby><cites>FETCH-LOGICAL-c379t-77543fa308dc7d374e86e44790155125118f900b05f946e70baabfcf0dda6bbf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jns.2004.01.013$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15738412$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15140603$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brilla, Roland</creatorcontrib><creatorcontrib>Block, Margo</creatorcontrib><creatorcontrib>Geremia, Glen</creatorcontrib><creatorcontrib>Wichter, Melvin</creatorcontrib><title>Clinical and neuroradiologic features of 39 consecutive cases of West Nile Virus meningoencephalitis</title><title>Journal of the neurological sciences</title><addtitle>J Neurol Sci</addtitle><description>Background: West Nile Virus (WNV) is a flavivirus WNV that has spread westwards across North America in recent years. It can cause a febrile illness and infection of the central nervous system, which is associated with poor outcome.
Methods: We retrospectively studied the clinical and neuroradiologic features of 39 consecutive patients admitted during summer of 2002 that had IgM in the cerebrospinal fluid positive for WNV.
Results: Fever, headache and altered mentation were predominant clinical features. Clinically significant involvement of lower motor neurons was seen in few cases. Magnetic resonance imaging (MRI) of the brain did not show changes attributable to meningitis or encephalitis except for one case of subcortical signal abnormalities. Unfavorable prognostic factors are old age, decreased level of alertness and elevated serum creatinine.
Conclusions: Encephalopathic presentations, with or without additional neurological focality, dominated this series. Fever and meningitic signs are often absent. Involvement of lower motor neurons was uncommon. Given the paucity of positive findings, the value of MRI to support the diagnosis of WNV-meningoencephalitis is limited.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Brain - pathology</subject><subject>Brain - physiopathology</subject><subject>Child</subject><subject>Enzyme-Linked Immunosorbent Assay - methods</subject><subject>Female</subject><subject>Focal findings</subject><subject>Humans</subject><subject>Immunoglobulin M - metabolism</subject><subject>Lower motor neuron involvement</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Meningoencephalitis</subject><subject>Meningoencephalitis - cerebrospinal fluid</subject><subject>Meningoencephalitis - diagnostic imaging</subject><subject>Meningoencephalitis - physiopathology</subject><subject>Meningoencephalitis - virology</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Prognostic factors</subject><subject>Radionuclide Imaging</subject><subject>Retrospective Studies</subject><subject>West Nile Virus</subject><issn>0022-510X</issn><issn>1878-5883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE2LFDEQhoMo7rj6A7xILnrrsarT3UnjSYb1Axa9-HUL6aSyZuhJxqR7wX9vhhnQk_BCQfFU8fIw9hxhi4DD6_12H8u2Bei2gDXiAdugkqrplRIP2QagbZse4ccVe1LKHgAGpcbH7Ap77GAAsWFuN4cYrJm5iY5HWnPKxoU0p7tguSezrJkKT56LkdsUC9l1CffErSnn_XcqC_8UZuLfQl4LP1AM8S5RtHT8aeawhPKUPfJmLvTsMq_Z13c3X3YfmtvP7z_u3t42VshxaaTsO-GNAOWsdEJ2pAbqOjkC9j22PaLyI8AEvR-7gSRMxkzeenDODNPkxTV7df57zOnXWnvpQyiW5tlESmvREkfsx0FUEM-gzamUTF4fcziY_Fsj6JNavddVrT6p1YA1p5sXl-frdCD39-LisgIvL4ApVajPJtpQ_uGkUB22lXtz5qiquA-UdbHhpMuFTHbRLoX_1PgD3y-XZQ</recordid><startdate>20040515</startdate><enddate>20040515</enddate><creator>Brilla, Roland</creator><creator>Block, Margo</creator><creator>Geremia, Glen</creator><creator>Wichter, Melvin</creator><general>Elsevier B.V</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20040515</creationdate><title>Clinical and neuroradiologic features of 39 consecutive cases of West Nile Virus meningoencephalitis</title><author>Brilla, Roland ; Block, Margo ; Geremia, Glen ; Wichter, Melvin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c379t-77543fa308dc7d374e86e44790155125118f900b05f946e70baabfcf0dda6bbf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Brain - pathology</topic><topic>Brain - physiopathology</topic><topic>Child</topic><topic>Enzyme-Linked Immunosorbent Assay - methods</topic><topic>Female</topic><topic>Focal findings</topic><topic>Humans</topic><topic>Immunoglobulin M - metabolism</topic><topic>Lower motor neuron involvement</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Meningoencephalitis</topic><topic>Meningoencephalitis - cerebrospinal fluid</topic><topic>Meningoencephalitis - diagnostic imaging</topic><topic>Meningoencephalitis - physiopathology</topic><topic>Meningoencephalitis - virology</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Prognostic factors</topic><topic>Radionuclide Imaging</topic><topic>Retrospective Studies</topic><topic>West Nile Virus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brilla, Roland</creatorcontrib><creatorcontrib>Block, Margo</creatorcontrib><creatorcontrib>Geremia, Glen</creatorcontrib><creatorcontrib>Wichter, Melvin</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the neurological sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brilla, Roland</au><au>Block, Margo</au><au>Geremia, Glen</au><au>Wichter, Melvin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical and neuroradiologic features of 39 consecutive cases of West Nile Virus meningoencephalitis</atitle><jtitle>Journal of the neurological sciences</jtitle><addtitle>J Neurol Sci</addtitle><date>2004-05-15</date><risdate>2004</risdate><volume>220</volume><issue>1</issue><spage>37</spage><epage>40</epage><pages>37-40</pages><issn>0022-510X</issn><eissn>1878-5883</eissn><coden>JNSCAG</coden><abstract>Background: West Nile Virus (WNV) is a flavivirus WNV that has spread westwards across North America in recent years. It can cause a febrile illness and infection of the central nervous system, which is associated with poor outcome.
Methods: We retrospectively studied the clinical and neuroradiologic features of 39 consecutive patients admitted during summer of 2002 that had IgM in the cerebrospinal fluid positive for WNV.
Results: Fever, headache and altered mentation were predominant clinical features. Clinically significant involvement of lower motor neurons was seen in few cases. Magnetic resonance imaging (MRI) of the brain did not show changes attributable to meningitis or encephalitis except for one case of subcortical signal abnormalities. Unfavorable prognostic factors are old age, decreased level of alertness and elevated serum creatinine.
Conclusions: Encephalopathic presentations, with or without additional neurological focality, dominated this series. Fever and meningitic signs are often absent. Involvement of lower motor neurons was uncommon. Given the paucity of positive findings, the value of MRI to support the diagnosis of WNV-meningoencephalitis is limited.</abstract><cop>Shannon</cop><pub>Elsevier B.V</pub><pmid>15140603</pmid><doi>10.1016/j.jns.2004.01.013</doi><tpages>4</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Biological and medical sciences Brain - pathology Brain - physiopathology Child Enzyme-Linked Immunosorbent Assay - methods Female Focal findings Humans Immunoglobulin M - metabolism Lower motor neuron involvement Magnetic resonance imaging Magnetic Resonance Imaging - methods Male Medical sciences Meningoencephalitis Meningoencephalitis - cerebrospinal fluid Meningoencephalitis - diagnostic imaging Meningoencephalitis - physiopathology Meningoencephalitis - virology Middle Aged Neurology Prognostic factors Radionuclide Imaging Retrospective Studies West Nile Virus |
| title | Clinical and neuroradiologic features of 39 consecutive cases of West Nile Virus meningoencephalitis |
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