A Case Report of Long-Latency Evoked Diaphragm Potentials After Exposure To Acute Intermittent Hypoxia in Post-West Nile Virus Meningoencephalitis

Authors

Joseph F. Welch
Erica A. Dale
Jayakrishnan Nair, Thomas Jefferson UniversityFollow
Paul W. Davenport
Emily J. Fox
Gordon S. Mitchell

Document Type

Article

Publication Date

12-31-2024

Comments

This article is the author's final published version in Journal of Neurophysiology, Volume 133, Issue 2, February 2025, pages 522-529 .

The published version is available at https://doi.org/10.1152/jn.00406.2024.

Copyright © 2025 The Author(s).

Abstract

We present a case report of a 42-year-old female with post-West Nile virus meningoencephalitis who exhibited unique, long-latency diaphragm potentials evoked by transcranial and cervical magnetic stimulation after exposure to acute intermittent hypoxia (AIH). The subject was recruited for a study investigating AIH effects on respiratory motor function in healthy individuals. She had contracted West Nile virus infection 5 years before assessment that resulted in hospitalization and persistent allodynia but was not reported to the research team. During the study, transcranial (TMS) and cervical (CMS) magnetic stimulation were performed before and 30-60 min after a single presentation of AIH [15, 1-min hypoxic episodes (∼9% inspired O2), with 1-min normoxic intervals]. Diaphragm EMG was recorded using chest wall surface electrodes. At baseline, evoked diaphragm potentials were within normal ranges for both TMS (onset latency ¼ 17.0 ± 1.1 ms; peak-to-peak amplitude ¼ 220 ± 27 lV) and CMS (onset latency ¼ 7.8 ± 0.6 ms; peak-to-peak amplitude ¼ 336 ± 8 lV). However, long-latency TMS- and CMS-evoked potentials were observed 30–60 min post-AIH that were not present at baseline nor in healthy subjects. The onset of long-latency potentials ranged from 50 to 808 ms. While AIH is a potentially useful therapeutic strategy to enhance motor function after neurological disease or injury, it may elicit distinct effects in individuals with a history of neuroinfectious disease. Possible explanations for these unusual responses are discussed.

Recommended Citation

Welch, Joseph F.; Dale, Erica A.; Nair, Jayakrishnan; Davenport, Paul W.; Fox, Emily J.; and Mitchell, Gordon S., "A Case Report of Long-Latency Evoked Diaphragm Potentials After Exposure To Acute Intermittent Hypoxia in Post-West Nile Virus Meningoencephalitis" (2024). Department of Physical Therapy Faculty Papers. Paper 43.
https://jdc.jefferson.edu/ptfp/43

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.

PubMed ID

39852952

Language

English