All issues > Volume 36(4); 1993

Original Article

J Korean Pediatr Soc. 1993;36(4):485-494. Published online April 15, 1993.

A Clinical Study on Aseptic Meningitis Combined with Polio-Like Paralysis

Woong Young WY Moon¹, Ki Soo KS Kim¹, Young Seo YS Park¹, Hyung Nam HN Moon¹, Chang Yee CY Hong¹, Dae Chul DC Suh², Si Joon SJ Yu³, In Young IY Seong³, Young Min YM Ahn⁴

¹Department of Pediatrics, College of Medicine, University of Ulsan, Seoul, Korea
²Department of Radiology, College of Medicine, University of Ulsan, Seoul, Korea
³Department of Rehabilitation, College of Medicine, University of Ulsan, Seoul, Korea
⁴Department of Pediatrics, Kangnam General Hospital, Seoul, Korea

Abstract

We clinically reviewed four patients who were suffering from aseptic meningitis combined with polio-like paralysis and performed radiological, neurological and virological studies on them. Three patients were admitted to the department of Pediatrics. Asan Medical Center from March to August 1990, and one patient was admitted to the department of Pediatrics, Kangnam General Hospital. The results were as follows: 1) During the period of study, 18 patients(10.1%) our of 178 aseptic meningitis patients also suffered from hand, foot and mouth disease, and three patients(1.69%) out of 178 patients also suffering from polio-like paralysis. 2) The age of the patients who also suffered from polio-like paralysis were eight months, 22 months, 23months and four years old respectively. Three patients were male and one patient was female. 3) Paralysis developed three to five days after asepitc meningitis infection. 4) In two cases, Magnetic Resonance Imaging(MR) showed two small cavitary lesions that means anterior horn cell necrosis in concordant with residual paralysis. Axial T1-weighted image showed decreased signal intensity and axial t2-weighted image showed increased signal intensity. In another case 20 days after onset of illness MR was performed, the transverse myelitis showed mild swelling of cornus medullaris. Follow up MR in 2months revealed atropic change in lower thoracic spinal cord. 5) The electromyography and nerve conduction velocity test revealed acute polyradiculoneuropathy. 6) Serologic virus study were carried out in three cases for Coxsackievirus A16 and Enterovirus A16 and Enterovirus 71. The Enterovirus 71 antibody titer were less than 1:4. This study showed that the causative agents for polio-like paralysis during this period seemed to be the Enterovirus 71 infection.

Keywords :Aseptic meningitis, Polio-like paralysis, Enterovirus 71, Magnetic Resornance imaging