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Manifestaciones neurológicas y resultado de la infección por el virus del Nilo Occidental
James J Sejvar1, Maryam B Haddad, Bruce C Tierney
1Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, and Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Ga 30333, USA. zea3@cdc.gov
JAMA
|July 24, 2003
Resumen
La infección por el virus del Nilo Occidental (VNO) puede causar problemas neurológicos significativos, incluidos trastornos del movimiento y parálisis. Mientras que los pacientes con meningitis y encefalitis a menudo se recuperan, la parálisis flácida aguda puede conducir a una debilidad irreversible de las extremidades.
Área de la Ciencia:
- Neurología Neurología.
- Enfermedades infecciosas Enfermedades infecciosas.
- Salud Pública La salud pública.
Sus antecedentes:
- Las manifestaciones neurológicas de la infección por el virus del Nilo Occidental requieren una caracterización prospectiva.
- Existen datos limitados sobre los hallazgos de laboratorio y los resultados para los pacientes con WNV.
Objetivo del estudio:
- Documentar de forma prospectiva las características clínicas y de laboratorio de la infección por WNV.
- Para evaluar los resultados neurológicos a largo plazo en pacientes con WNV.
Principales métodos:
- Una serie de casos prospectivos se llevó a cabo en la parroquia de St. Tammany, Louisiana, del 1 de agosto al 2 de septiembre de 2002.
- Se recopilaron datos clínicos estandarizados para los casos sospechosos de WNV.
- Los pacientes confirmados seropositivos al WNV se sometieron a una nueva evaluación a los 8 meses.
Principales resultados:
- De los 39 casos sospechosos, 16 (37%) eran seropositivos para el WNV, presentándose con meningitis (5), encefalitis (8) o parálisis flácida aguda (3).
- Los trastornos del movimiento como temblor (94%), parkinsonismo (69%) y mioclono (31%) fueron comunes.
- A los 8 meses, se observaron fatiga persistente, dolor de cabeza, mialgias y trastornos de la marcha / movimiento; los pacientes con parálisis flácida aguda no recuperaron la fuerza de las extremidades.
Conclusiones:
- La infección por WNV puede manifestarse con trastornos significativos del movimiento durante la enfermedad aguda.
- Los pacientes con meningitis o encefalitis por WNV pueden lograr resultados favorables a largo plazo.
- La parálisis flácida aguda debido al WNV puede resultar en un síndrome irreversible parecido a la poliomielitis.
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