Bilateral Upper Extremity Tremors in West Nile Encephalitis

West Nile encephalitis, a rare complication of West Nile virus (WNv) infection, can present with symptoms mimicking other neurological diseases. This article reports a case of a 60-year-old female who developed bilateral upper extremity tremors with West Nile encephalitis. The patient presented with high fevers and new onset confusion, followed by persistent tremors throughout her hospitalization. Brain imaging showed no abnormalities, but cerebral spinal fluid (CSF) was positive for WNv IgM, confirming the diagnosis. When patients present with movement disorders and confusion, it often suggests brain or spinal cord injury or other neurological illnesses. However, viral etiologies should be considered, especially when fever and elevated white blood cell count are present.

• 1
  The 60-year-old female patient developed bilateral upper extremity tremors, high fever, and confusion, leading to a diagnosis of West Nile encephalitis.
• 2
  CSF analysis revealed pleocytosis and West Nile IgM, confirming the West Nile virus infection as the cause of the encephalitis.
• 3
  The patient's symptoms included seizures and altered mentation, which are consistent with encephalitis and highlight the neuroinvasive nature of the West Nile virus in this case.