Clinical characteristics analysis of 4 cases with acute flaccid myelitis in children
10.3760/cma.j.cn112140-20240320-00191
- VernacularTitle:儿童急性弛缓性脊髓炎4例临床特点分析
- Author:
Xiushan GE
1
;
Hui JIAO
;
Qian CHEN
;
Baoyuan ZHANG
;
Linqing ZHAO
;
Runan ZHU
;
Shupin LI
;
Caihui MA
;
Yuanyuan ZHANG
;
Xiaoyin PENG
Author Information
1. 首都儿科研究所附属儿童医院神经内科，北京 100020
- Keywords:
Child;
Acute flaccid myelitis;
Acute flaccid paralysis;
Enterovirus
- From:
Chinese Journal of Pediatrics
2024;62(7):676-680
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the clinical manifestations, diagnosis, treatment and prognosis of acute flaccid myelitis (AFM) in children.Methods:Clinical characteristics of 4 AFM cases from Department of Neurology, Children′s Hospital Affiliated to Capital Institute of Pediatrics, from September 2018 to November 2022, were analyzed retrospectively.Results:The age of 4 children with AFM was 7 years, 4 years and 3 months, 7 years and 1 month, 6 years and 5 months, respectively. There were 2 boys and 2 girls. Prodromal infection status showed 3 children of respiratory tract infection and 1 child of digestive tract infection. The main manifestation was asymmetrical limb weakness after infection, and the affected limb range was from monoplegia to quadriplegia. Cranial nerve injury was involved in 1 child, no encephalopathy. Magnetic resonance imaging in the spinal cord of all 4 children showed long T1 and T2 signals, mainly involving gray matter. Cerebrospinal fluid cell-protein separation was observed in 2 children. Pathogen detected in 1 child pharyngeal swab was enterovirus D68. Antibody IgM to adenovirus was positive in the blood of 1 child. Antibody IgG against Echo and Coxsackie B virus were positive in the blood of another child. After glucocorticoid, human immunoglobulin or simple symptomatic treatment and at the same time under later rehabilitation training, muscle strength recovered to different degrees, but there were disabilities left in 3 children.Conclusions:AFM should be considered in children with acute and asymmetrical flaccid paralysis accompanied by abnormal magnetic resonance imaging signal in the central region of spinal cord, especially post-infection. The effective treatment is limited and the prognosis is poor.
