title: Functional recovery from neuroinvasive West Nile Virus: A tale of two courses.
abstract: OBJECTIVE
  In 2012, the highest numbers of West Nile Virus (WNV) cases were reported by the Center for Disease Control since 2003. This outbreak included over half of the identified patients being classified with one of the more debilitating neuroinvasive subtypes of WNV. Despite improvements in diagnosis and treatment options in symptom management, longitudinal research on WNV neurocognitive and functional outcomes is limited by sample size, retrospective review, and/or reliance on self-report measures for cognitive status and level of independence. This study describes the cases of 2 patients diagnosed with WNV as they complete rehabilitation across the continuum of care.
  
  
  METHODS
  Review of two cases that experience different rehabilitation outcomes 4-18 months post diagnosis.
  
  
  RESULTS
  The cases presented here demonstrate the potentially differential courses of recovery and outcomes for physical (e.g., balance, ambulation, upper extremity function), cognitive (e.g., attention, executive functions, memory, language, visuospatial), and emotional functioning, as assessed via measures administered by the patient's physical therapists and neuropsychologists. These patients were evaluated as part of the standard clinical practice to monitor changes, track recovery, and provide recommendations across the continuum of care from admission to discharge from acute inpatient rehabilitation, during outpatient day neurorehabilitation, and while receiving outpatient neuropsychology services.
  
  
  CONCLUSIONS
  These cases highlight the variability in rehabilitative course for individuals diagnosed with WNV. Consistent follow-up with patients is recommended to ensure management of remitting and chronic symptoms.
authors.affiliation: Department of Neuropsychology, Baylor Institute for Rehabilitation.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Fromm
authors.affiliation: Department of Neuropsychology, Baylor Institute for Rehabilitation.
authors.forename: David B
authors.initials: DB
authors.lastname: Salisbury
authors.affiliation: Department of Research, Baylor Institute for Rehabilitation.
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Driver
authors.affiliation: Department of Research, Baylor Institute for Rehabilitation.
authors.forename: Marie N
authors.initials: MN
authors.lastname: Dahdah
authors.affiliation: Department of Surgery, Baylor University Medical Center.
authors.forename: Kimberley R
authors.initials: KR
authors.lastname: Monden
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D003131:Combined Modality Therapy; D004196:Disease Outbreaks; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057187:Independent Living / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis / Q000523:psychology* / Q000534:rehabilitation*; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D012050:Rehabilitation, Vocational; D012189:Retrospective Studies; D057566:Self Report; D013577:Syndrome; D014901:West Nile Fever / Q000175:diagnosis / Q000523:psychology* / Q000534:rehabilitation*