Electrodiagnostic features of acute paralytic poliomyelitis associated with West Nile virus infection
Electrodiagnostic features of acute paralytic poliomyelitis associated with West Nile virus infection
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DOI：
10.1002/mus.10557
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发表时间：
2004-03-01
期刊：
影响因子：
3.4
通讯作者：
Katirji, B
中科院分区：
文献类型：
--
作者：
Al-Shekhlee, A;Katirji, B
西尼罗河病毒（WNV）感染是一种潜在的致命疾病，脑膜脑炎是其最常见的神经系统表现。格林-巴利综合征（GBS）也有报道，但急性麻痹性脊髓灰质炎直到最近才得到确认。我们报告了5例西尼罗河病毒感染患者的临床和电诊断结果，他们表现为急性麻痹性脊髓灰质炎。3例患者表现为局灶性不对称无力，2例表现为酷似GBS的快速上升性四肢瘫痪。急性期电诊断显示感觉神经动作电位正常，复合运动动作电位振幅正常或降低，神经传导速度无减慢。视检查时间而定，颤电位分布广泛，包括局灶性虚弱者。1例颈核磁共振显示脊髓灰质t2加权信号异常。在随访中，一名患者出现临床改善迹象，而两名患者在发病5个月后仍然四肢瘫痪并依赖呼吸机。本报告强调了电诊断研究在与西尼罗病毒感染相关的急性麻痹性脊髓灰质炎引起的局灶性或全面性虚弱的诊断和预后中的价值。
West Nile virus (WNV) infection is a potentially fatal disease, with meningoencephalitis being its most common neurological manifestation. Guillain-Barre syndrome (GBS) has also been described, but acute paralytic poliomyelitis has only recently been recognized. We report the clinical and electrodiagnostic findings of five patients with WNV infection, who presented with acute paralytic poliomyelitis. Three patients manifested focal asymmetrical weakness, and two had rapid ascending quadriplegia mimicking GBS. Electrodiagnostic studies during the acute illness showed normal sensory nerve action potentials, compound motor action potentials of normal or reduced amplitude, and no slowing of nerve conduction velocities. Depending on the timing of the examination, fibrillation potentials were widespread, including in those with focal weakness. Cervical magnetic resonance imaging in one patient showed abnormal T2-weighted signals in the spinal cord gray matter. On follow-up, signs of clinical improvement were seen in one patient, whereas two remained quadriplegic and ventilator-dependent 5 months after the onset. This report highlights the value of the electrodiagnostic studies in the diagnosis and prognosis of focal or generalized weakness due to acute paralytic poliomyelitis associated with WNV infection.