Surreal illustration of a brain affected by West Nile Virus, symbolizing cognitive challenges.

West Nile Virus: Unmasking the Long-Term Neurological Impacts

Nico Varela in Health & Wellness December 2025 • 4 min read.

"A Korean Case Study Highlights the Subtle But Significant Cognitive and Psychiatric Effects Following West Nile Encephalitis"

West Nile virus (WNV) is a global health concern, notorious for its potential to cause severe neurological complications. While many infected individuals remain asymptomatic, a significant portion develops West Nile fever, and a smaller percentage experiences neuroinvasive diseases like encephalitis. These conditions can leave lasting impacts on cognitive and psychiatric well-being.

This article delves into a fascinating case study from Korea, documenting the neuropsychological and psychiatric challenges faced by a patient following West Nile virus encephalitis. This is particularly significant as it marks the first reported imported case of West Nile virus infection in Korea, offering valuable insights into the virus's long-term effects.

The case highlights the importance of recognizing and addressing the subtle yet debilitating cognitive and psychiatric sequelae that can arise after WNV infection, emphasizing the need for comprehensive rehabilitation and ongoing monitoring.

The Case: Unveiling the Subtle Neurological Impact of West Nile Virus

Surreal illustration of a brain affected by West Nile Virus, symbolizing cognitive challenges.

A 58-year-old man, previously healthy and working as an office worker, was admitted to the Department of Rehabilitation Medicine after experiencing a series of neurological symptoms. Prior to his admission, he had traveled to Ghana for business, where he developed a persistent headache. Upon returning to Korea, he was diagnosed with West Nile encephalitis after presenting with a constellation of symptoms including headache, mild weakness, sensory changes, gait disturbance, and urinary issues.

MRI scans revealed multifocal lesions in critical brain regions, including the basal ganglia and internal capsule, indicative of encephalitis. Elevated West Nile virus-specific IgG ELISA titers confirmed the diagnosis. Initially treated with intravenous interferon-α, the patient was later transferred to rehabilitation for comprehensive care.

Cognitive Impairment: Difficulties with memory, attention, and executive functions.
Psychiatric Symptoms: Depressive mood, somatic delusions (such as the sensation of worms in his ear or gas emanating from his body), and health concerns.
Functional Limitations: Weakness, balance problems, and reduced endurance affecting daily activities.

Despite improvements in physical symptoms through rehabilitation, the patient continued to experience significant neuropsychological and psychiatric challenges. Psychological assessments revealed minimal depression on the Beck's Depression Inventory but elevated scores on the Minnesota Multiphasic Personality Inventory II, particularly in scales related to depression, hypochondriasis, and schizophrenia. These findings suggested a complex interplay of cognitive and emotional disturbances.

The Long View: Why Monitoring and Support are Key

This case underscores the importance of long-term monitoring and comprehensive rehabilitation for individuals affected by West Nile virus encephalitis. While physical symptoms may improve with therapy, the subtle neuropsychological and psychiatric sequelae can persist, significantly impacting quality of life. Recognizing and addressing these challenges is crucial for ensuring optimal recovery and well-being.

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This article is based on research published under:

DOI-LINK: 10.12786/bn.2014.7.2.131, Alternate LINK

Title: Neuropsychological And Psychiatric Impairment After West Nile Virus Encephalitis In Korean: A Case Report

Subject: General Medicine

Journal: Brain & Neurorehabilitation

Publisher: Korean Society for Neurorehabilitation

Authors: Tae Im Yi, Bo Kyoung Kim, Seung A Ha, Ji Young Lim, Jea Shin Han

Published: 2014-01-01

Everything You Need To Know

What is West Nile Virus and what does it do?

West Nile virus (WNV) is a global health concern with the potential to cause severe neurological complications. While many infected individuals remain asymptomatic, some develop West Nile fever and a smaller percentage experience neuroinvasive diseases like encephalitis, which can lead to lasting impacts on cognitive and psychiatric well-being.

Can you summarize the case study presented?

The case study details a 58-year-old man, previously healthy, who contracted West Nile encephalitis after traveling to Ghana. He presented with symptoms including headache, weakness, sensory changes, gait disturbance, and urinary issues. MRI scans showed lesions in critical brain regions, confirming the diagnosis. The patient was treated with intravenous interferon-α initially and later transferred to rehabilitation for comprehensive care.

What were the key symptoms and challenges faced by the patient in this case?

The patient exhibited cognitive impairment like memory and attention issues, psychiatric symptoms such as depressive mood and somatic delusions, and functional limitations including weakness and balance problems. Psychological assessments revealed minimal depression but elevated scores on scales related to depression, hypochondriasis, and schizophrenia, showing a complex interplay of cognitive and emotional disturbances.

Why is long-term monitoring and rehabilitation important for those affected by West Nile virus encephalitis?

The study highlights the importance of long-term monitoring and comprehensive rehabilitation for individuals affected by West Nile virus encephalitis. While physical symptoms may improve, the subtle neuropsychological and psychiatric sequelae can persist. Addressing these challenges is crucial for ensuring optimal recovery and well-being, necessitating ongoing care.

What makes this case study so important and what insights does it offer?

The study's significance lies in its focus on the subtle but debilitating long-term cognitive and psychiatric sequelae after WNV infection. This first reported imported case of West Nile virus infection in Korea provides valuable insights into these long-term effects, emphasizing the need for comprehensive rehabilitation and ongoing monitoring to improve patient outcomes and quality of life.