Dancing eyes: a case of opsoclonus, tremor and truncal ataxia secondary to West Nile encephalitis
Bibliographic record
Abstract
Background: Opsoclonus can result from paraneoplastic, parainfectious, autoimmune, ischemic or toxic etiologies. Neuroinvasive complications develop in less than one percent of individuals infected with West Nile Virus. Methods: Case report. Results: A 63-year-old female presented with subacute disorientation, dizziness, oscillopsia, and unsteady gait, associated with fever. Examination demonstrated opsoclonus, bilateral upper extremity postural and action tremor and truncal ataxia. MRI of the brain was normal. CT of the body showed no evidence of neoplasia. Vasculitic and paraneoplastic panels were negative. An extensive infectious work-up was only positive for West Nile IgM antibodies. She was treated with clonazepam and received a five-day-course of IVIG. Her symptoms improved after treatment and she continued to demonstrate gradual recovery during the months following her discharge. Conclusions: There are only a few published case reports of WNV-associated opsoclonus, and our patient appears to be the oldest reported with this constellation of neurological symptoms. Even though treatment for WNV is mostly supportive, this case demonstrates the importance of a thorough work-up in patients of similar presentations to determine the etiology and to guide early immunomodulation in selected cases. Video available.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".