Abstract Details

Title Cauda Equina Syndrome in the Setting of West Nile virus

Topic Infectious Disease

Presentation(s) P11 - Poster Session 11 (11:45 AM-12:45 PM)

Poster/Presentation
Number 3-007

Objective Our objective is to showcase the possibility of West Nile Virus causing an atypical presentation of cauda equina syndrome

Background 63M presents with 6 days of ongoing saddle anesthesia, urinary retention and bilateral feet paresthesia. Symptoms came on acutely without traumatic onset. He started developing balance difficulties leading him to seek further medical management.

Design/Methods We performed a MRI Brain + T and L spine WWO. He had 2 lumbar punctures. Meningitis/Encephalitis panel was sent along with CSF culture including gram stain/fungal/acid fast bacilli

Results He had a MRI Brain, T/L spine WWO showing enhancement and mild thickening of the ventral cauda equina nerve roots. Two lumbar punctures were performed showing mild lymphocytic pleocytosis (13) with increment (27) on the subsequent lumbar puncture. Protein was elevated as well (128/176). There were no central cord enhancement concerning for transverse myelitis. His CSF West Nile IgM came back positive (2.58).

Conclusions We had a 63M presenting cauda equina syndrome due to non-traumatic etiology. After extensive workup with spinal imaging and CSF analysis, it was proved to be due to West Nile Virus from CSF and serum IgM confirmation. It is an interesting case presentation where West Nile Virus did not cause the typical cord syndrome or motor neuron disease, but rather cauda equina involvement.

Authors/Disclosures
Ronny Yip PRESENTER	Dr. Yip has nothing to disclose.
Daniel Goldstein	Daniel Goldstein has nothing to disclose.
Michael Pennell, MD	Michael Pennell has nothing to disclose.

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