All issues > Volume 44(11); 2001

Case Report

J Korean Pediatr Soc. 2001;44(11):1305-1310. Published online November 15, 2001.

A Case of Polio-like Encephalomyelitis Associated with Enterovirus 71 Infection

Hyun Kyung HK Roh¹, Hee Jung HJ Chung², Young Mee YM Jee³, Doo Sung DS Cheon³

¹Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea
²Department of Pediatrics, National Health Insurance Corporation, Ilsan Hospital, Koyang, Korea
³Department of Virology, Laboratory of Enteroviruses, National Institute of Health, Seoul, Korea

Correspondence Hee Jung HJ Chung ,Email: agathac@NHIMC.or.kr

Abstract

Enterovirus 71(EV71), like polioviruses, invades the central nervous system to give rise to aseptic meningitis, encephalitis or myelitis. EV71 was first isolated in California in 1969 from a 9-month- old infant with encephalitis. Since then it has been isolated from the brain of children who died of encephalitis and from feces of patients with meningitis, encephalitis or paralysis. Related strains have been isolated from outbreaks of similar diseases in Australia, Sweden, Bulgaria and Hungary. We have experienced polio-like encephalomyelitis in a 3-month-old girl. Initial brain MR imaging showed tissue destruction in the bilateral posterior portions of the medulla oblongata and the bilateral anterior horns of cervical spinal cord from C3 to C6 level. Follow-up MR imaging was performed 3 months later, which showed minimal residual change on the anterior horn of the cervical spinal cord at C4 level only. This report deals with rare polio-like encephalomyelitis associated with EV71 and discusses its diagnosis and management. Brain stem and cervical spinal cord involvement are characteristic findings of EV encephalomyelitis.

Keywords :Enterovirus 71, Polio-like encephalomyelitis, Serious CNS complications