Mewasingh Leena D, Christiaens Florence J C, Dachy Bernard, Christophe Catherine, Dan Bernard
Department of Paediatric Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium.
Pediatr Neurol. 2004 Jan;30(1):54-6. doi: 10.1016/s0887-8994(03)00421-1.
Although subacute ascending paralysis without sensory involvement is typically evocative of Guillain-Barré syndrome, it can alternatively be due to infection or inflammation of the spinal cord. We describe a 16-month-old female who presented with ascending flaccid paresis after an upper respiratory tract infection. She then developed signs of upper motor neuron involvement of the lower limbs associated with upper motor neuron involvement of the upper limbs. Motor nerve conduction and electromyographic studies of upper limbs demonstrated anterior horn cell involvement. Neuroimaging was consistent with cervical myelitis, and cerebrospinal fluid polymerase chain reaction was positive for herpesvirus-1. Although association with the primary infection of the respiratory tract may be fortuitous, possible neurotropic or hematogenous spread of herpesvirus-1 to the cervical spinal cord cannot be excluded. She then developed signs of upper motor neuron involvement of the lower limbs associatred with lower motor neuron involvement of the upper limbs [corrected].
虽然无感觉受累的亚急性上行性麻痹通常使人联想到吉兰 - 巴雷综合征，但它也可能是由脊髓感染或炎症引起的。我们描述了一名16个月大的女性，她在上呼吸道感染后出现了上行性弛缓性麻痹。随后，她出现了下肢上运动神经元受累的体征，并伴有上肢上运动神经元受累。上肢的运动神经传导和肌电图研究显示前角细胞受累。神经影像学检查结果与颈髓炎相符，脑脊液聚合酶链反应显示疱疹病毒 -1呈阳性。虽然与呼吸道原发性感染的关联可能是偶然的，但不能排除疱疹病毒 -1向颈髓的潜在神经嗜性或血行播散。随后，她出现了下肢上运动神经元受累的体征，并伴有上肢下运动神经元受累[已修正]。
