West Nile Virus Encephalitis Involving the Substantia Nigra

Bosanko, C M; Gilroy, John; Wang, Ay-Ming; Sanders, William P.; Dulai, Mohanpal; Wilson, Jon D.; Blum, Keith

doi:10.1001/archneur.60.10.1448

Cited by 74 publications

(26 citation statements)

References 10 publications

(10 reference statements)

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“…As mentioned above, MRI has revealed heavy involvement of the substantia nigra in a WNV patient with Parkinsonism features (Bosanko et al, 2003). Other than these examples, MRI findings in patients with WNND are generally nonspecific (Petropoulou et al, 2005).…”

Section: Introductionmentioning

confidence: 93%

“…Parkinson’s disease is a neurodegenerative disease caused by death of dopaminergic neurons in the substantia nigra. Two WNV patients have been described by neuroimaging procedures with heavy involvement of the substantia nigra, which correlated with Parkinsonism features of the patient (Bosanko et al, 2003). It is not known if rodents have Parkinsonism, but hamsters infected with WNV manifest front limb tremors (Morrey et al, 2004b).…”

Section: Introductionmentioning

confidence: 98%

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Neurological approaches for investigating West Nile virus disease and its treatment in rodents

2013

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West Nile virus (WNV) has had a major public health impact since its emergence in the Western Hemisphere; in 2012, nearly 3000 cases of WN neuroinvasive disease were identified in the United States. The underlying mechanisms of WN neurologic disease can only be studied to a limited extent in patients, but can be investigated in much greater detail in animal models. In this paper, we describe how we and others have employed a variety of electrophysiological and neurological techniques to study experimental WNV infections in hamsters and mice. The methods have included electrophysiological motor unit number estimation; optogenetic photoactivation of the spinal cord and electromyography; plethysmography; measurement of heart rate variability as an indication of autonomic nervous system dysfunction; and an assessment of spatial memory loss using the Morris water maze. These techniques provide a more refined assessment of disease manifestations in rodents than traditional measurements of weight loss and mortality, and should make it possible to identify targets for therapeutic intervention and to directly assess the effects of novel treatments.

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Section: Introductionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 98%

Neurological approaches for investigating West Nile virus disease and its treatment in rodents

2013

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“…The development of these movement disorders in WNE is due to specific neurotropism of WNV for extrapyramidal structures; there is frequent involvement of the brainstem (particularly, the medulla and pons), the deep gray matter nuclei, particularly the substantia nigra of the basal ganglia and the thalami, and the cerebellum [25,26,27]. This clinico-pathologic correlation may be extended to the neuroimaging abnormalities seen in West Nile encephalitis.…”

Section: Clinical Syndromes Associated With Wnv Infectionmentioning

confidence: 99%

Clinical Manifestations and Outcomes of West Nile Virus Infection

Sejvar

2014

Viruses

204

177

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Since the emergence of West Nile virus (WNV) in North America in 1999, understanding of the clinical features, spectrum of illness and eventual functional outcomes of human illness has increased tremendously. Most human infections with WNV remain clinically silent. Among those persons developing symptomatic illness, most develop a self-limited febrile illness. More severe illness with WNV (West Nile neuroinvasive disease, WNND) is manifested as meningitis, encephalitis or an acute anterior (polio) myelitis. These manifestations are generally more prevalent in older persons or those with immunosuppression. In the future, a more thorough understanding of the long-term physical, cognitive and functional outcomes of persons recovering from WNV illness will be important in understanding the overall illness burden.

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“…Our findings, in common with those of others, show that the thalamus was the structure most frequently involved, followed by the cortex. Interestingly, thalamic lesions have been reported in many other arboviral encephalitides, including Eastern equine encephalitis [6], West Nile virus encephalitis, [3,30,38] Murray Valley encephalitis [9], tick borne encephalitis [19,20] and dengue encephalitis [16]. The reason why lesions to the thalamus and other basal ganglia occur in arboviral encephalitis is not known.…”

Section: Discussionmentioning

confidence: 99%

An evaluation of the usefulness of neuroimaging for the diagnosis of Japanese encephalitis

et al. 2009

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Japanese encephalitis virus (JEV) is estimated to cause 30–50,000 cases of encephalitis every year. The disease occurs mainly in rural Asia and is transmitted to humans from birds and pigs by mosquitoes of the genus Culex. JE is diagnosed with antibody testing of the serum and CSF, but this is not available in many hospitals. Neuroimaging abnormalities, particularly thalamic hypodensity on computed tomography (CT) and hyperintensity on T2 weighted magnetic resonance imaging (MRI) have been described in case studies, but their usefulness for diagnosing JE is not known. We have therefore evaluated the usefulness of neuroimaging (CT and MRI) for the diagnosis of JE. The findings of thalamic lesions were compared with the final serological diagnosis in a cohort of 75 patients (children and adults) with suspected CNS infections in Southern Vietnam, a JEV endemic area. Thalamic lesions on CT and/or MRI combined had sensitivity 23% (95% confidence interval 12.9–33.1%), specificity 100%, positive predictive value 100% and negative predictive value 42.1% (95% confidence interval 30.2–53.8%) for a diagnosis of JE in this cohort. Over time, the thalamic lesions resolved in some patients. One patient showed disappearance of lesions on CT followed by reappearance of the lesions some time later, known as the fogging effect. In this setting, the presence of thalamic abnormalities suggested the diagnosis of JE, but their absence did not exclude it.

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West Nile Virus Encephalitis Involving the Substantia Nigra

Cited by 74 publications

References 10 publications

Neurological approaches for investigating West Nile virus disease and its treatment in rodents

Neurological approaches for investigating West Nile virus disease and its treatment in rodents

Clinical Manifestations and Outcomes of West Nile Virus Infection

An evaluation of the usefulness of neuroimaging for the diagnosis of Japanese encephalitis

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