Acute anterior radiculitis associated with West Nile virus infection
- Cook County Hospital and Rush-Presbyterian-St Luke’s Medical Center, 1725 West Harrison Street, Suite 1118, Chicago, IL 60612, USA
- Correspondence to: Dr Margaret Park; margaret_park{at}rush.edu
Our knowledge of neurological syndromes associated with West Nile virus (WNV) infection continues to evolve. Recent reports during the 1999 outbreak in New York City have most commonly described an encephalitis and aseptic meningitis associated with the infection, but muscle weakness was also found to be an unexpected but prominent feature.1 Although electrodiagnostic testing in some cases revealed a predominantly axonal polyneuropathy, the mechanism of this weakness remains unclear. The first attempt to account for WNV associated weakness was described in a 1979 case report, suggesting acute anterior myelitis as the aetiology.2 More recently, involvement of the anterior horn cell was implicated in several cases of WNV poliomyelitis, as localised by electrodiagnostic studies.3,4 We present the first known case of a WNV poliomyelitis-like syndrome with associated magnetic resonance imaging (MRI) findings, and propose an alternate explanation for the associated weakness.
Case report
A 29 year old right handed man with no significant past medical history reported symptoms of fever, myalgia, nausea, vomiting, and neck stiffness several days after a fishing trip in the Chicago metropolitan area in August 2002. Simultaneously with these symptoms, he described dull, non-radiating …
