Background: West Nile virus (WNV) is an uncommon arbovirus infection and is usually asymptomatic in pediatric patients and due to its rarity is not very well known by clinicians.
Case: We present a 5-year-old girl admitted to the Pediatric Emergency Service with fever, vomiting, neck stiffness, walking difficulty and sudden deviation of eyes who was diagnosed with a neuroinvasive WNV infection.
Conclusions: Ophthalmoplegia is an unusual presentation of neuroinvasive WNV and there are no published pediatric cases with ophthalmoplegia in the literature.
Keywords: West Nile Virus; ataxia; children; ophthalmoplegia.