A 51-year-old man developed severe, subacute onset right facial weakness and flaccid, hyporeflexic right upper limb weakness several days following West Nile virus infection. Electrophysiologic and radiographic studies confirmed severe but incomplete right facial and brachial plexus neuropathies (figure). There were no clinical or laboratory findings to suggest encephalitis or myelitis. For additional details regarding his diagnosis, see appendix e-1 on the Neurology® Web site at www.neurology.org.
Figure Coronal short tau inversion recovery MRI demonstrating thickening and T2 signal prolongation in the right (symptomatic) brachial plexus (broad arrow)
The contralateral (asymptomatic) brachial plexus (narrow yellow arrow) appears normal.
Since its arrival in North America, West Nile virus infection has been associated with a number of neuromuscular manifestations,1 such as a poliomyelitis-like motor neuronopathy, Guillain-Barré syndrome, isolated brachial plexus neuropathy, and now multifocal neuropathy. MRI continues to emerge as a useful tool in the evaluation of neuromuscular disorders.2
Footnotes
-
Supplemental data at www.neurology.org
Disclosure: Dr. Jones has received federal grant support. Dr. Sumner has nothing to disclose.
Letters: Rapid online correspondence
REQUIREMENTS
If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Hemiplegic Migraine Associated With PRRT2 Variations A Clinical and Genetic Study
Dr. Robert Shapiro and Dr. Amynah Pradhan