Cargando…

Neurologic Manifestations of Enterovirus 71 Infection in Korea

Enterovirus 71 frequently involves the central nervous system and may present with a variety of neurologic manifestations. Here, we aimed to describe the clinical features, magnetic resonance imaging (MRI) findings, and cerebrospinal fluid (CSF) profiles of patients presenting with neurologic compli...

Descripción completa

Detalles Bibliográficos
Autores principales: Lee, Kyung Yeon, Lee, Myoung Sook, Kim, Dong Bin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Academy of Medical Sciences 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4810339/
https://www.ncbi.nlm.nih.gov/pubmed/27051240
http://dx.doi.org/10.3346/jkms.2016.31.4.561
_version_ 1782423786917724160
author Lee, Kyung Yeon
Lee, Myoung Sook
Kim, Dong Bin
author_facet Lee, Kyung Yeon
Lee, Myoung Sook
Kim, Dong Bin
author_sort Lee, Kyung Yeon
collection PubMed
description Enterovirus 71 frequently involves the central nervous system and may present with a variety of neurologic manifestations. Here, we aimed to describe the clinical features, magnetic resonance imaging (MRI) findings, and cerebrospinal fluid (CSF) profiles of patients presenting with neurologic complications of enterovirus 71 infection. We retrospectively reviewed the records of 31 pediatric patients hospitalized with acute neurologic manifestations accompanied by confirmed enterovirus 71 infection at Ulsan University Hospital between 2010 and 2014. The patients’ mean age was 2.9 ± 5.5 years (range, 18 days to 12 years), and 80.6% of patients were less than 4 years old. Based on their clinical features, the patients were classified into 4 clinical groups: brainstem encephalitis (n = 21), meningitis (n = 7), encephalitis (n = 2), and acute flaccid paralysis (n = 1). The common neurologic symptoms included myoclonus (58.1%), lethargy (54.8%), irritability (54.8%), vomiting (48.4%), ataxia (38.7%), and tremor (35.5%). Twenty-five patients underwent an MRI scan; of these, 14 (56.0%) revealed the characteristic increased T2 signal intensity in the posterior region of the brainstem and bilateral cerebellar dentate nuclei. Twenty-six of 30 patients (86.7%) showed CSF pleocytosis. Thirty patients (96.8%) recovered completely without any neurologic deficits; one patient (3.2%) died due to pulmonary hemorrhage and shock. In the present study, brainstem encephalitis was the most common neurologic manifestation of enterovirus 71 infection. The characteristic clinical symptoms such as myoclonus, ataxia, and tremor in conjunction with CSF pleocytosis and brainstem lesions on MR images are pathognomonic for diagnosis of neurologic involvement by enterovirus 71 infection.
format Online
Article
Text
id pubmed-4810339
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher The Korean Academy of Medical Sciences
record_format MEDLINE/PubMed
spelling pubmed-48103392016-04-05 Neurologic Manifestations of Enterovirus 71 Infection in Korea Lee, Kyung Yeon Lee, Myoung Sook Kim, Dong Bin J Korean Med Sci Original Article Enterovirus 71 frequently involves the central nervous system and may present with a variety of neurologic manifestations. Here, we aimed to describe the clinical features, magnetic resonance imaging (MRI) findings, and cerebrospinal fluid (CSF) profiles of patients presenting with neurologic complications of enterovirus 71 infection. We retrospectively reviewed the records of 31 pediatric patients hospitalized with acute neurologic manifestations accompanied by confirmed enterovirus 71 infection at Ulsan University Hospital between 2010 and 2014. The patients’ mean age was 2.9 ± 5.5 years (range, 18 days to 12 years), and 80.6% of patients were less than 4 years old. Based on their clinical features, the patients were classified into 4 clinical groups: brainstem encephalitis (n = 21), meningitis (n = 7), encephalitis (n = 2), and acute flaccid paralysis (n = 1). The common neurologic symptoms included myoclonus (58.1%), lethargy (54.8%), irritability (54.8%), vomiting (48.4%), ataxia (38.7%), and tremor (35.5%). Twenty-five patients underwent an MRI scan; of these, 14 (56.0%) revealed the characteristic increased T2 signal intensity in the posterior region of the brainstem and bilateral cerebellar dentate nuclei. Twenty-six of 30 patients (86.7%) showed CSF pleocytosis. Thirty patients (96.8%) recovered completely without any neurologic deficits; one patient (3.2%) died due to pulmonary hemorrhage and shock. In the present study, brainstem encephalitis was the most common neurologic manifestation of enterovirus 71 infection. The characteristic clinical symptoms such as myoclonus, ataxia, and tremor in conjunction with CSF pleocytosis and brainstem lesions on MR images are pathognomonic for diagnosis of neurologic involvement by enterovirus 71 infection. The Korean Academy of Medical Sciences 2016-04 2016-02-22 /pmc/articles/PMC4810339/ /pubmed/27051240 http://dx.doi.org/10.3346/jkms.2016.31.4.561 Text en © 2016 The Korean Academy of Medical Sciences. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Lee, Kyung Yeon
Lee, Myoung Sook
Kim, Dong Bin
Neurologic Manifestations of Enterovirus 71 Infection in Korea
title Neurologic Manifestations of Enterovirus 71 Infection in Korea
title_full Neurologic Manifestations of Enterovirus 71 Infection in Korea
title_fullStr Neurologic Manifestations of Enterovirus 71 Infection in Korea
title_full_unstemmed Neurologic Manifestations of Enterovirus 71 Infection in Korea
title_short Neurologic Manifestations of Enterovirus 71 Infection in Korea
title_sort neurologic manifestations of enterovirus 71 infection in korea
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4810339/
https://www.ncbi.nlm.nih.gov/pubmed/27051240
http://dx.doi.org/10.3346/jkms.2016.31.4.561
work_keys_str_mv AT leekyungyeon neurologicmanifestationsofenterovirus71infectioninkorea
AT leemyoungsook neurologicmanifestationsofenterovirus71infectioninkorea
AT kimdongbin neurologicmanifestationsofenterovirus71infectioninkorea