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Volume 9, Number 7—July 2003
Research

Acute Flaccid Paralysis and West Nile Virus Infection

James J. Sejvar*Comments to Author , A. Arturo Leis†, Dobrivoje S. Stokic†, Jay A. Van Gerpen‡, Anthony A. Marfin*, Risa Webb§, Maryam B. Haddad*, Bruce C. Tierney*, Sally A. Slavinski§, Jo Lynn Polk†, Victor Dostrow†, Michael Winkelmann†, and Lyle R. Petersen*
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †Methodist Rehabilitation Center, Jackson, Mississippi, USA; ‡Ochsner Clinic, New Orleans, Louisiana, USA; §Mississippi State Department of Health, Jackson, Mississippi, USA

Main Article

Table 4

Clinical characteristics of patients with West Nile virus–associated acute flaccid paralysis compared with patients with typical Guillain-Barré syndrome (25–27)a

Characteristic West Nile virus–associated flaccid paralysis Guillain-Barré syndrome
Timing of onset
Acute phase of infection
1–8 weeks after acute infection
Fever and leukocytosis
Present
Absent
Weakness distribution
Asymmetric; occasional monoplegia
Generally symmetric; proximal and distal muscles
Sensory symptoms
Absence of numbness, paresthesias, or sensory loss; occasional myalgias
Painful distal paresthesias and sensory loss
Bowel/bladder involvement
Often present
Rare
Concurrent encephalopathy
Often present
Absent
CSF profile
Pleocytosis and elevated protein
No pleocytosis; elevated protein (albuminocytologic dissociation)
Electrodiagnostic features Anterior horn cell/motor axon: reduced/absent CMAPs, preserved SNAPs; asymmetric denervation Demyelination: marked slowing of conduction velocity; conduction block, temporal dispersion; reduced SNAPs

aCSF, cerebrospinal fluid; CMAPs, compound muscle action potentials; SNAPSs, sensory nerve action potentials.

Main Article

Page created: December 22, 2010
Page updated: December 22, 2010
Page reviewed: December 22, 2010
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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