Abstract
Marciniak C, Sorosky S, Hynes C. Acute flaccid paralysis associated with West Nile
virus: motor and functional improvement in 4 patients.
Objective
To describe motor and functional recovery in 4 patients with acute flaccid paralysis
associated with West Nile virus (WNV) infection.
Design
A case series describing patient clinical features at admission to rehabilitation
through 6-month follow-up.
Setting
Academic acute free-standing inpatient rehabilitation hospital.
Participants
The patients (3 men, 1 woman; age range, 29–72y) with central nervous system WNV infection
presented on rehabilitation admission, 18 to 112 days after onset of symptoms, with
severe flaccid asymmetric weakness without sensory loss, and decreased functional
independence. Electrodiagnostic studies demonstrated a severe diffuse motor axonopathy
consistent with an anterior myelitis.
Intervention
Acute inpatient rehabilitation program over a period of 35 to 106 days.
Main outcome measures
Motor and FIM instrument scores at admission to rehabilitation, discharge, and 6-month
follow-up.
Results
All patients showed modest improvements in strength and function; no patient made
full recovery of strength or became ambulatory by 6-month follow-up.
Conclusions
Little is known about recovery in patients with WNV-associated anterior myelitis.
It will be important to document any further improvements in strength and function
in such patients over a longer follow-up period.
Key words
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No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
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Copyright
© 2004 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
