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Pediatric Neurology
Volume 48, Issue 5, May 2013, Pages 393?396
Case Report
Unusual Case of West Nile Virus Flaccid Paralysis in a 10-Year-Old Child
Farouq I. Thabet, MDCorresponding author contact information, E-mail the corresponding author,
Sarah E. Servinsky, DO,
Fareeha Naz, MD,
Teresa E. Kovas, MD,
Timur O. Raghib, MD
Abstract
West Nile virus infection is asymptomatic in most cases. West Nile virus neuroinvasive disease includes encephalitis, meningitis, and/or acute flaccid paralysis. In children, acute flaccid paralysis as the solo presentation of West Nile virus disease is rare. It develops abruptly and progresses rapidly early in the disease course. We report on a 10-year-old child who presented with a slowly progressive left leg flaccid paralysis over 4 weeks. He tested positive for West Nile virus in both blood and cerebrospinal fluid. Spinal MRI showed enhancement of the ventral nerve roots. This was also supported by electrophysiological studies. One week after the plateauing of his left leg paralysis, he was readmitted to the hospital with left hand weakness. Complete recovery of his recurrent weakness was observed after prompt 5-day course of intravenous immunoglobulin G therapy. However, no improvement was noticed in the left foot drop. To our knowledge, this is the first case report of West Nile virus disease in children presented with a slowly progressive flaccid paralysis, and a recurrent weakness recovered after intravenous immunoglobulin G administration.
Corresponding author contact information
Communications should be addressed to: Dr. Thabet; 901 East Mt. Hope Hwy.; Lansing, MI 48910.
Copyright ? 2013 Elsevier Inc. All rights reserved.
Volume 48, Issue 5, May 2013, Pages 393?396
Case Report
Unusual Case of West Nile Virus Flaccid Paralysis in a 10-Year-Old Child
Farouq I. Thabet, MDCorresponding author contact information, E-mail the corresponding author,
Sarah E. Servinsky, DO,
Fareeha Naz, MD,
Teresa E. Kovas, MD,
Timur O. Raghib, MD
Abstract
West Nile virus infection is asymptomatic in most cases. West Nile virus neuroinvasive disease includes encephalitis, meningitis, and/or acute flaccid paralysis. In children, acute flaccid paralysis as the solo presentation of West Nile virus disease is rare. It develops abruptly and progresses rapidly early in the disease course. We report on a 10-year-old child who presented with a slowly progressive left leg flaccid paralysis over 4 weeks. He tested positive for West Nile virus in both blood and cerebrospinal fluid. Spinal MRI showed enhancement of the ventral nerve roots. This was also supported by electrophysiological studies. One week after the plateauing of his left leg paralysis, he was readmitted to the hospital with left hand weakness. Complete recovery of his recurrent weakness was observed after prompt 5-day course of intravenous immunoglobulin G therapy. However, no improvement was noticed in the left foot drop. To our knowledge, this is the first case report of West Nile virus disease in children presented with a slowly progressive flaccid paralysis, and a recurrent weakness recovered after intravenous immunoglobulin G administration.
Corresponding author contact information
Communications should be addressed to: Dr. Thabet; 901 East Mt. Hope Hwy.; Lansing, MI 48910.
Copyright ? 2013 Elsevier Inc. All rights reserved.