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Titolo:
Neurologic complications in children with enterovirus 71 infection
Autore:
Huang, CC; Liu, CC; Chang, YC; Chen, CY; Wang, ST; Yeh, TF;
Indirizzi:
Natl Cheng Kung Univ, Coll Med, Dept Pediat, Tainan 704, Taiwan Natl ChengKung Univ Tainan Taiwan 704 , Dept Pediat, Tainan 704, Taiwan Natl Cheng Kung Univ, Coll Med, Dept Publ Hlth, Tainan 704, Taiwan Natl Cheng Kung Univ Tainan Taiwan 704 ept Publ Hlth, Tainan 704, Taiwan Chang Gung Childrens Hosp, Dept Pediat, Kaohsiung, Taiwan Chang Gung Childrens Hosp Kaohsiung Taiwan pt Pediat, Kaohsiung, Taiwan Triserv Gen Hosp & Natl Def Med Ctr, Dept Radiol, Taipei, Taiwan Triserv Gen Hosp & Natl Def Med Ctr Taipei Taiwan adiol, Taipei, Taiwan
Titolo Testata:
NEW ENGLAND JOURNAL OF MEDICINE
fascicolo: 13, volume: 341, anno: 1999,
pagine: 936 - 942
SICI:
0028-4793(19990923)341:13<936:NCICWE>2.0.ZU;2-N
Fonte:
ISI
Lingua:
ENG
Soggetto:
BRAIN-STEM ENCEPHALITIS; CENTRAL NERVOUS-SYSTEM; MOUTH-DISEASE; POLIOMYELITIS; MRI; PARALYSIS; OUTBREAK; HAND; FOOT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Huang, CC Natl Cheng Kung Univ, Coll Med, Dept Pediat, 138 Sheng Li Rd, Tainan 704, Taiwan Natl Cheng Kung Univ 138 Sheng Li Rd Tainan Taiwan 704 , Taiwan
Citazione:
C.C. Huang et al., "Neurologic complications in children with enterovirus 71 infection", N ENG J MED, 341(13), 1999, pp. 936-942

Abstract

Background Enterovirus 71 infection causes hand-foot-and-mouth disease in young children, which is characterized by several days of fever and vomiting, ulcerative lesions in the oral mucosa, and vesicles on the backs of the hands and feet. The initial illness resolves bur is sometimes followed by aseptic meningitis, encephalomyelitis, or even acute flaccid paralysis similar to paralytic poliomyelitis. Methods We describe the neurologic complications associated with the enterovirus 71 epidemic that occurred in Taiwan in 1998. At three major hospitals we identified 41 children with culture-confirmed entero; virus 71 infection and acute neurologic manifestations. Magnetic resonance imaging (MRI) was performed in 4 patients with acute flaccid paralysis and 24 with rhombencephalitis. Results The mean age of the patients was 2.5 years (range, 3 months to 8.2years). Twenty-eight patients had hand-foot-and-mouth disease (68 percent), and six had herpangina (15 percent). The other seven patients had no skinor mucosal lesions. Three neurologic syndromes were identified: aseptic meningitis tin 3 patients); brain-stem encephalitis, or rhombencephalitis (in37); and acute flaccid paralysis (in 4), which followed rhombencephalitis in 3 patients. In 20 patients with rhombencephalitis, the syndrome was characterized by myoclonic jerks and tremor, ataxia, or both (grade I disease). Ten patients had myoclonus and cranial-nerve involvement (grade II disease). In seven patients the brain-stem infection produced transient myoclonus followed by the rapid onset of respiratory distress, cyanosis, poor peripheral perfusion, shock, coma, loss of the doll's eye reflex, and apnea (gradeIII disease); five of these patients died within 12 hours after admission. In 17 of the 24 patients with rhombencephalitis who underwent MRI, T-2-weighted scans showed high-intensity lesions in the brain stem, most commonly in the pontine tegmentum. At follow-up, two of the patients with acute flaccid paralysis had residual limb weakness, and five of the patients with rhombencephalitis had persistent neurologic deficits, including myoclonus tin one child), cranial-nerve deficits (in two), and ventilator-dependent apnea(in two). Conclusions In the 1998 enterovirus 71 epidemic in Taiwan, the chief neurologic complication was rhombencephalitis, which had a fatality rare of 14 percent. The most common initial symptoms were myoclonic jerks, and MRI usually showed evidence of brainstem involvement. (N Engl J Med 1999;341:936-42. ) (C) 1999, Massachusetts Medical Society.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 11/07/20 alle ore 04:17:00