West Nile virus (WNV) is a neurotropic Flavivirus transmitted primarily through mosquito bites, with Culex species being the main vectors. While most WNV infections remain asymptomatic or present with mild flu-like symptoms, neuroinvasive disease occurs in approximately 1 in 150 cases, leading to meningitis, encephalitis, or acute flaccid paralysis.
Brainstem encephalitis is a rare but severe manifestation of WNV neuroinvasive disease, characterized by cranial nerve dysfunction, ophthalmoplegia, dysphagia, ataxia, and respiratory failure. The brainstem's involvement can lead to life-threatening complications, necessitating early recognition and supportive management.
Here, we present a case of West Nile virus infection which had all the dreadful complications of this virus including multiple cranial nerve palsies,movement disorder and autonomic dysfunction that finally resulted in cardiac and respiratory failure .The relevance of this case is to highlight on its diagnostic challenges, and management, with a focus on its distinct neurological features.
KEYWORDS:brainstem encephalitis,west nile virus(WNV),flavi-virus
