To demonstrate the possible utility of interferon alpha as a treatment for severe West Nile neuroinvasive disease (WNND).

This was a 61-year old male with history of lower back pain who initially presented to an outside hospital with fall due to sudden onset bilateral lower extremity weakness and progressive urinary and bowel incontinence in the setting of fevers and chills over the past 2-3 days. An MRI t-spine showed a T2 hyperintense lesion extending from T8 to the conus. He quickly became encephalopathic as well. He was treated with a course of high dose steroids and IVIG without any improvements. He was then started on a 14-day course of interferon alpha 2b more than two weeks after initial presentation.

On day 3 of interferon alpha 2b therapy, patient began to show some clinical improvements in mental status, upper extremity weakness, and bowel incontinence. However, he continued to have bilateral lower extremity weakness and urinary incontinence.