Agamanolis Dimitri P, Leslie Michael J, Caveny Elizabeth A, Guarner Jeannette, Shieh Wun-Ju, Zaki Sherif R
Department of Pathology, Children's Hospital Medical Center of Akron, OH 44308, USA.
Ann Neurol. 2003 Oct;54(4):547-51. doi: 10.1002/ana.10731.
A 67-year-old woman had fever, myalgias, progressive weakness, and respiratory insufficiency. In 9 days, flaccid areflexic quadriparesis and bulbar palsy developed. She died 26 days after the onset of her illness. Serum and cerebrospinal fluid serology were positive for West Nile virus. Neuropathological study showed changes consistent with a viral encephalomyelitis, similar to poliomyelitis. The brainstem showed neuronal loss and multiple foci of necrosis. The spinal cord showed severe loss of anterior and posterior horn neurons. Immunohistochemistry identified West Nile virus antigens in the brainstem and spinal cord. Paralysis, in West Nile virus encephalitis, is caused by destruction of motor neurons.
一名67岁女性出现发热、肌痛、进行性肌无力和呼吸功能不全。9天后，出现弛缓性无反射性四肢瘫和延髓麻痹。发病26天后死亡。血清和脑脊液血清学检测显示西尼罗河病毒呈阳性。神经病理学研究显示与病毒性脑脊髓炎一致的变化，类似于脊髓灰质炎。脑干显示神经元丢失和多个坏死灶。脊髓显示前角和后角神经元严重丢失。免疫组织化学在脑干和脊髓中鉴定出西尼罗河病毒抗原。在西尼罗河病毒性脑炎中，麻痹是由运动神经元的破坏引起的。
