Rehabilitation Outcomes in Subjects with West Nile Neuro-Invasive Disease

Abstract

West Nile Virus (WNV) is the most common mosquito borne cause of viral encephalitis in the United States. Physical and neuro-cognitive recovery from WNND may be prolonged or incomplete leading to chronic cognitive inefficiencies and functional decline. There continues to be no effective treatment of WNV and current management is primarily supportive. The objective of this review is to evaluate the functional outcomes and role of rehabilitation services in subjects with WNND. The charts of five subjects admitted to an acute inpatient brain injury rehabilitation facility from June to December 2012 were retrospectively reviewed. (Mean, Range)-Age (64.8, 43-78 years), Admission Functional Independence Measure (FIM) (45.2, 14-63), Discharge FIM (82.2, 61-100), FIM score gain (37, 24-60), Cognitive FIM gain (7, 1-18), Mobility FIM gain (17.4, 13-20), ADL FIM gain (12.6, 4-23); acute brain injury inpatient rehabilitation facility length of stay (LOS) (17.8, 14-21 days); acute hospital LOS (15, 10-22 days). Of the five subjects, three were discharged home, one was discharged to a skilled nursing facility, and one was discharged to an assisted living facility. Subjects with WNND have significant functional decline across all FIM subcategories and may benefit from a course of brain injury-specific acute inpatient rehabilitation.

Keywords: West Nile Neuro-invasive Disease; West Nile Virus; acute inpatient brain injury rehabilitation; outcomes.

Figure 1

Functional Independence Measure.

Figure 2

Subject 1 admission and discharge functional independence measure scores.

Figure 3

Subject 2 admission and discharge functional independence measure scores.

Figure 4

Subject 3 admission and discharge functional independence measure scores.

Figure 5

Subject 4 admission and discharge functional independence measure scores.

Figure 6

Subject 5 admission and discharge functional independence measure scores.