{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T20:06:47Z","timestamp":1793995607173,"version":"4.8.0"},"reference-count":22,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2016,2,16]],"date-time":"2016-02-16T00:00:00Z","timestamp":1455580800000},"content-version":"unspecified","delay-in-days":4308,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can. j. neurol. sci."],"published-print":{"date-parts":[[2004,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0317167100053828_abs1\"><jats:title>Background:<\/jats:title><jats:p>Over the past four years, West Nile virus (WNV) has become a significant health issue in North America. In 2002, WNV infection made its first appearance in the human population in Canada.<\/jats:p><\/jats:sec><jats:sec id=\"S0317167100053828_abs2\"><jats:title>Methods:<\/jats:title><jats:p>Patients who presented to the University Health Network and Mount Sinai Hospital in Toronto with neurological disease attributed to WNV infection were identified and followed by the neurology service. Clinical features and results of laboratory, electrodiagnostic, radiological and pathological studies are presented.<\/jats:p><\/jats:sec><jats:sec id=\"S0317167100053828_abs3\"><jats:title>Results:<\/jats:title><jats:p>In August and September 2002, 26 patients were admitted with WNV infection; 14 presented with neurological illness. Encephalitis was the most common presentation (11 patients). Eleven patients developed neuromuscular disease; two at presentation and nine after encephalitis. While the majority had a motor process that localized to the anterior horn cell and\/or motor neuron, two patients had evidence of a demyelinating neuropathy and one a sensorimotor axonal neuropathy. Less common manifestations included rhombencephalitis, ataxia, myelopathy and parkinsonism. Death occurred in four patients; two &gt; 75 years of age, and two who were immunocompromised.<\/jats:p><\/jats:sec><jats:sec id=\"S0317167100053828_abs4\"><jats:title>Conclusions:<\/jats:title><jats:p>The most common neurological manifestation of WNV infection was encephalitis with subsequent neuromuscular involvement. The diversity of clinical and pathological findings, however, suggests widespread involvement of the central and peripheral nervous system. A poorer prognosis for neurological recovery and overall survival was seen in older and immunocompromised patients.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0317167100053828","type":"journal-article","created":{"date-parts":[[2016,2,17]],"date-time":"2016-02-17T09:27:41Z","timestamp":1455701261000},"page":"185-193","source":"Crossref","is-referenced-by-count":65,"title":["Neurological Manifestations of West Nile Virus Infection"],"prefix":"10.1017","volume":"31","author":[{"given":"Jodie M.","family":"Burton","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph Z.","family":"Kern","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Halliday","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Mikulis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Brunton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Fearon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin","family":"Pepperell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Jaigobin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2016,2,16]]},"reference":[{"key":"S0317167100053828_ref022","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.4.524"},{"key":"S0317167100053828_ref020","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa030969"},{"key":"S0317167100053828_ref019","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa022987"},{"key":"S0317167100053828_ref018","doi-asserted-by":"publisher","DOI":"10.1002\/ana.10575"},{"key":"S0317167100053828_ref010","unstructured":"Centers for Disease Control and Prevention. Epidemic\/epizootic West Nile virus in the United States: revised guidelines for surveillance, prevention, and control. Available at: http:\/\/www.cdc.gov\/ncidod\/dvbid\/westnile\/resources\/wnv-guidelines-apr-2001.pdf. Accessed May 5, 2003."},{"key":"S0317167100053828_ref001","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2001.tb02707.x"},{"key":"S0317167100053828_ref006","first-page":"675","volume":"7","author":"Chowers","year":"2001","journal-title":"Clinical characteristics of the West Nile fever outbreak, Israel, 2000"},{"key":"S0317167100053828_ref021","doi-asserted-by":"publisher","DOI":"10.1086\/378278"},{"key":"S0317167100053828_ref009","doi-asserted-by":"crossref","first-page":"1823","DOI":"10.1128\/JCM.38.5.1823-1826.2000","article-title":"Standardization of immunoglobulin M capture enzyme-linked immunosorbent assays for routine diagnosis of arboviral infections","volume":"38","author":"Martin","year":"2000","journal-title":"J Clin Microbiol"},{"key":"S0317167100053828_ref005","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-137-3-200208060-00009"},{"key":"S0317167100053828_ref015","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-510X(02)00135-1"},{"key":"S0317167100053828_ref004","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)05480-0"},{"key":"S0317167100053828_ref012","doi-asserted-by":"publisher","DOI":"10.3201\/eid0704.017420"},{"key":"S0317167100053828_ref008","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1958.7.561"},{"key":"S0317167100053828_ref002","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200106143442401"},{"key":"S0317167100053828_ref003","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(02)00368-7"},{"key":"S0317167100053828_ref007","unstructured":"Halton Region Public Health. WNV surveillance data in Halton 2002. 5-13-0003. Ref Type: Internet Communication."},{"key":"S0317167100053828_ref011","first-page":"1399","article-title":"West Nile virus infection in 2002: morbidity and mortality among patients admitted to hospital in southcentral Ontario","volume":"168","author":"Pepperell","year":"2003","journal-title":"Can Med Assoc J"},{"key":"S0317167100053828_ref013","doi-asserted-by":"publisher","DOI":"10.1097\/00005072-195610000-00007"},{"key":"S0317167100053828_ref014","doi-asserted-by":"publisher","DOI":"10.1354\/vp.37-3-208"},{"key":"S0317167100053828_ref016","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.4.511"},{"key":"S0317167100053828_ref017","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000073617.08185.0A"}],"container-title":["Canadian Journal of Neurological Sciences \/ Journal Canadien des Sciences Neurologiques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0317167100053828","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,15]],"date-time":"2020-09-15T16:03:11Z","timestamp":1600185791000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0317167100053828\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,5]]},"references-count":22,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2004,5]]}},"alternative-id":["S0317167100053828"],"URL":"https:\/\/doi.org\/10.1017\/s0317167100053828","relation":{},"ISSN":["0317-1671","2057-0155"],"issn-type":[{"value":"0317-1671","type":"print"},{"value":"2057-0155","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,5]]}}}