The neurobehavioural consequences of St. Louis encephalitis infection

Background: St. Louis encephalitis (SLE) is a relatively common cause of neurological illness, yet little is known about its cognitive and psychosocial consequences. Purpose: To describe the cognitive, emotional, psychophysiological, and psychosocial consequences of SLE infection. Method: A comprehensive neuropsychological and psychophysiological evaluation of a high functioning woman 6 weeks and 1 year after acute SLE infection is presented. The focus and course of rehabilitation is also examined. Results: The primary cognitive consequences of SLE infection involved attention, working memory, speed of processing, and cognitive efficiency. Depression was also observed. Psychometric testing suggested that these deficits largely resolved after 1 year. Conclusions: SLE produces neurocognitive deficits which are reflected in both psychometric and psychophysiologic measures and functional status. Psychometric and vocational improvement were observed over 1 year. However, the normal vocational return came at a significant psychosocial cost. This case emphasizes the importance of a comprehensive neuropsychological evaluation and illustrates the importance of an integrated rehabilitation programme.