Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Education
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Online Sections
    • Neurology Video Journal Club
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Null Hypothesis
    • Patient Pages
    • Translations
    • Topics A-Z
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Education
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Online Sections
    • Neurology Video Journal Club
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Null Hypothesis
    • Patient Pages
    • Translations
    • Topics A-Z
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center
  • Home
  • Articles
  • Issues
  • Practice Current
  • Practice Buzz

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology Clinical Practice
Home
A peer-reviewed clinical neurology journal for the practicing neurologist
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Articles
  • Issues
  • Practice Current
  • Practice Buzz

Share

October 2021; 11 (5) Review

Eastern Equine Encephalitis

Case Series in Southern New England and Review of the Literature

Mayra Montalvo, Dana Ayoub, Michael McGary, Katrina Byrd, Leana Mahmoud, Leonard Mermel, Bradford Thompson, Linda Wendell
First published April 14, 2021, DOI: https://doi.org/10.1212/CPJ.0000000000001079
Mayra Montalvo
Department of Neurology (M. Montalvo), Mayo Clinic, Rochester, MN; Rhode Island Hospital (DA, L. Mahmoud), Providence; and Brown University (M. McGary, KB, L. Mermel, BT, LW), Providence, RI.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Dana Ayoub
Department of Neurology (M. Montalvo), Mayo Clinic, Rochester, MN; Rhode Island Hospital (DA, L. Mahmoud), Providence; and Brown University (M. McGary, KB, L. Mermel, BT, LW), Providence, RI.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michael McGary
Department of Neurology (M. Montalvo), Mayo Clinic, Rochester, MN; Rhode Island Hospital (DA, L. Mahmoud), Providence; and Brown University (M. McGary, KB, L. Mermel, BT, LW), Providence, RI.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Katrina Byrd
Department of Neurology (M. Montalvo), Mayo Clinic, Rochester, MN; Rhode Island Hospital (DA, L. Mahmoud), Providence; and Brown University (M. McGary, KB, L. Mermel, BT, LW), Providence, RI.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Leana Mahmoud
Department of Neurology (M. Montalvo), Mayo Clinic, Rochester, MN; Rhode Island Hospital (DA, L. Mahmoud), Providence; and Brown University (M. McGary, KB, L. Mermel, BT, LW), Providence, RI.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Leonard Mermel
Department of Neurology (M. Montalvo), Mayo Clinic, Rochester, MN; Rhode Island Hospital (DA, L. Mahmoud), Providence; and Brown University (M. McGary, KB, L. Mermel, BT, LW), Providence, RI.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Bradford Thompson
Department of Neurology (M. Montalvo), Mayo Clinic, Rochester, MN; Rhode Island Hospital (DA, L. Mahmoud), Providence; and Brown University (M. McGary, KB, L. Mermel, BT, LW), Providence, RI.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Linda Wendell
Department of Neurology (M. Montalvo), Mayo Clinic, Rochester, MN; Rhode Island Hospital (DA, L. Mahmoud), Providence; and Brown University (M. McGary, KB, L. Mermel, BT, LW), Providence, RI.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Full PDF
Citation
Eastern Equine Encephalitis
Case Series in Southern New England and Review of the Literature
Mayra Montalvo, Dana Ayoub, Michael McGary, Katrina Byrd, Leana Mahmoud, Leonard Mermel, Bradford Thompson, Linda Wendell
Neurol Clin Pract Oct 2021, 11 (5) e714-e721; DOI: 10.1212/CPJ.0000000000001079

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
99

Share

  • Article
  • Figures & Data
  • Info & Disclosures
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Abstract

Purpose of Review To describe the clinical presentation, diagnosis, management, and outcomes of 4 confirmed Eastern equine encephalitis (EEE) cases and a review of the literature.

Recent Findings There was a sharp rise in the number of EEE cases in the United States in 2019, with 38 confirmed cases and 15 deaths. Our institution cared for 10% of patients with neuroinvasive EEE nationwide. These were the first cases seen locally since 2010.

Summary EEE virus causes one of the most lethal types of arboviral encephalitis in the United States with a mortality of 30%–40%. Manifestations of EEE infections can range from mild encephalopathy to coma. Common findings include CSF pleocytosis and involvement of the basal ganglia on MRI. Given the rarity of this disease and nonspecific findings, diagnosis can be challenging, and a high clinical suspicion is important. Management is mainly supportive, and the use of IV immunoglobulin remains controversial. Two of our 4 patients died; these patients had coma within 48 hours, hyponatremia, involvement of bilateral thalami and brainstem, status epilepticus, and severe brain dysfunction in EEG.

Footnotes

  • Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.

  • Received June 6, 2020.
  • Accepted December 14, 2020.
  • © 2021 American Academy of Neurology
View Full Text

AAN Members

We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.

Google Safari Microsoft Edge Firefox

Click here to login

AAN Non-Member Subscribers

Click here to login

Purchase access

For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)

Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here 

Purchase
Individual access to articles is available through the Add to Cart option on the article page.  Access for 1 day (from the computer you are currently using) is US$ 39.00.  Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means.  The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use.  Distributing copies (electronic or otherwise) of the article is not allowed.

The Nerve!: Rapid online correspondence

No comments have been published for this article.
Comment

REQUIREMENTS

If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org

Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.

If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.

Submission specifications:

  • Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
  • Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
  • Submit only on articles published within 6 months of issue date.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Publishing Agreement Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
    • Abstract
    • Methods
    • Case Series
    • Discussion
    • Conclusion
    • Study Funding
    • Disclosure
    • Appendix Authors
    • Footnotes
    • References
  • Figures & Data
  • Info & Disclosures
Advertisement

Preferences and User Experiences of Wearable Devices in Epilepsy A Systematic Review and Mixed-Methods Synthesis

Dr. Daniel Friedman and Dr. Sharon Chiang

► Watch

Related Articles

  • No related articles found.

Alert Me

  • Alert me when eletters are published
Neurology: Clinical Practice: 13 (1)

Articles

  • Articles
  • Issues
  • Popular Articles

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Education
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology: Clinical Practice |  Print ISSN: 2163-0402
Online ISSN: 2163-0933

© 2023 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise