[Features of spinal cord MRI findings and clinical follow-up study on 8 children with hand-foot-and-mouth disease and acute flaccid paralysis].

OBJECTIVE

To understand the features of magnetic resonance imaging (MRI) findings and the results of clinical follow-up study in 8 infants and children with hand-foot-and-mouth disease (HFMD) complicated with acute flaccid paralysis (AFP) who were admitted to Beijing Ditan Hospital during the outbreak of HFMD in 2008.

METHODS

The clinical characteristics of the 8 HFMD cases were investigated, and MRI findings were analyzed. The recovery of their impairment in limbs was followed up for three months.

RESULTS

All the 8 cases showed poliomyelitis-like syndrome. MRI of spinal cord showed unilateral or bilateral hyperintense lesions which chiefly occurred in the anterior horn regions of the spinal cord (C(2)-C(7) or T(12)-L(1)) on T(1)/T(2)-weighted images. Lesions of spinal cord chiefly occurred in T(12)-L(1). Most of the cases showed mild paralysis, which occurred in more than half of cases in single lower extremity. The patients who had acute paralysis of single lower extremity recovered faster than those with paralysis of four limbs.

CONCLUSIONS

In HFMD with AFP cases, MRI of spinal cord showed unilateral or bilateral lesions in the anterior horn regions of the spinal cord (C(2)-C(7) or T(12)-L(1)) on T(1)/T(2)-weighted images. AFP may be to some degree reversible in HFMD cases. MRI can directly and completely show the range and degree of changes associated with AFP in HFMD cases, thus provide instructive suggestions to its treatment. The acute paralysis of HFMD cases may be benefited from earlier treatment for AFP.