Initial screening could be done using the ELISA technique detecting immunoglobulins in the sera of the tested individuals.Typical findings of WNV infection include lymphocytic pleocytosis, elevated protein level, reference glucose and lactic acid levels, and no erythrocytes.Definitive diagnosis of WNV is obtained through detection of virus-specific antibody IgM and neutralizing antibodies. Cases of West Nile virus meningitis and encephalitis that have been serologically confirmed produce similar degrees of CSF pleocytosis and are often associated with substantial CSF neutrophilia. Specimens collected within eight days following onset of illness may not test positive for West Nile IgM, and testing should be repeated. A positive test for West Nile IgG in the absence of a positive West Nile IgM is indicative of a previous flavivirus infection and is not by itself evidence of an acute West Nile virus infection.If cases of suspected West Nile virus infection, sera should be collected on both the acute and
convalescent phases of the illness. Convalescent specimens should be collected 2–3 weeks after acute specimens. It is common in serologic testing for cross-reactions to occur among flaviviruses such as dengue virus (DENV) and tick-borne encephalitis virus; this necessitates caution when evaluating serologic results of flaviviral infections.Four FDA-cleared WNV IgM ELISA kits are commercially available from different manufacturers in the U.S., each of these kits is indicated for use on serum to aid in the presumptive laboratory diagnosis of WNV infection in patients with clinical symptoms of meningitis or encephalitis.
The IASPs Classification of Chronic Pain does not have a diagnosis that corresponds to AFP, although it is listed in the differential diagnosis of "Glossodynia and sore mouth" (Burning mouth syndrome). However, in another IASP publication from 2011, the term PIFP is used and defined almost identically to the above. Despite the controversy surrounding the use of the term, it has a long history, and it is still in common use by clinicians to refer to chronic facial pain that does not meet any diagnostic criteria and does not respond to most treatments. Re-classification of trigeminal neuralgia
Trigeminal neuralgia is another example of a cause of facial pain. Neuralgia refers to pain in the distribution of a nerve (or nerves), and commonly implies paroxysmal (sudden) pain, although the accepted IASP definition specifies that the term should not be restricted to mean paroxysmal pain. Classic trigeminal neuralgia refers to sudden, shooting pain in the face, which is usually short lived and brought on by accidental stimulation of trigger points on the face, as may occur when washing. Trigeminal neuralgia has been described as one of the most painful conditions possible. Trigeminal neuralgia and AFP are traditionally considered separate, since AFP typically involves constant, often burning pain and trigeminal neuralgia classically shows paroxysmal, shooting pain, but in reality there is some overlap in their features. In 2005 researchers proposed a new classification of trigeminal neuralgia which described a type of trigeminal neuralgia where the pain was constant and burning.