title: Acute flaccid paralysis associated with West Nile virus: motor and functional improvement in 4 patients.
abstract: OBJECTIVE
  To describe motor and functional recovery in 4 patients with acute flaccid paralysis associated with West Nile virus (WNV) infection.
  
  
  METHODS
  A case series describing patient clinical features at admission to rehabilitation through 6-month follow-up.
  
  
  METHODS
  Academic acute free-standing inpatient rehabilitation hospital.
  
  
  METHODS
  The patients (3 men, 1 woman; age range, 29-72 y) 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.
  
  
  METHODS
  Acute inpatient rehabilitation program over a period of 35 to 106 days.
  
  
  METHODS
  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.
authors.affiliation: Northwestern University, Feinberg School of Medicine and the Rehabilitation Institute of Chicago, Chicago, IL 60611, USA. cmarciniak@ric.org
authors.forename: Christina
authors.initials: C
authors.lastname: Marciniak
authors.forename: Susan
authors.initials: S
authors.lastname: Sorosky
authors.forename: Christina
authors.initials: C
authors.lastname: Hynes
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001369:Axons / Q000502:physiology; D004185:Disability Evaluation; D004568:Electrodiagnosis; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000502:physiology; D009187:Myelitis / Q000503:physiopathology / Q000821:virology; D009431:Neural Conduction / Q000502:physiology; D010243:Paralysis / Q000503:physiopathology / Q000534:rehabilitation* / Q000821:virology*; D020127:Recovery of Function / Q000502:physiology; D014901:West Nile Fever / Q000503:physiopathology*; D014902:West Nile virus