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2014年8月至9月,科罗拉多州儿童病因不明的急性神经系统疾病

Acute neurologic illness of unknown etiology in children - Colorado, August-September 2014.

作者信息

Pastula Daniel M, Aliabadi Negar, Haynes Amber K, Messacar Kevin, Schreiner Teri, Maloney John, Dominguez Samuel R, Davizon Emily Spence, Leshem Eyal, Fischer Marc, Nix W Allan, Oberste M Steven, Seward Jane, Feikin Daniel, Miller Lisa

出版信息

MMWR Morb Mortal Wkly Rep. 2014 Oct 10;63(40):901-2.

Abstract

On September 12, 2014, CDC was notified by the Colorado Department of Public Health and Environment of a cluster of nine children evaluated at Children's Hospital Colorado with acute neurologic illness characterized by extremity weakness, cranial nerve dysfunction (e.g., diplopia, facial droop, dysphagia, or dysarthria), or both. Neurologic illness onsets occurred during August 8-September 15, 2014. The median age of the children was 8 years (range = 1-18 years). Other than neck, back, or extremity pain in some patients, all had normal sensation. All had a preceding febrile illness, most with upper respiratory symptoms, occurring 3-16 days (median = 7 days) before onset of neurologic illness. Seven of eight patients with magnetic resonance imaging of the spinal cord had nonenhancing lesions of the gray matter of the spinal cord spanning multiple levels, and seven of nine with magnetic resonance imaging of the brain had nonenhancing brainstem lesions (most commonly the dorsal pons). Two of five with magnetic resonance imaging of the lumbosacral region had gadolinium enhancement of the ventral nerve roots of the cauda equina. Eight children were up to date on polio vaccination. Eight have not yet fully recovered neurologically.

摘要

2014年9月12日,科罗拉多州公共卫生与环境部向美国疾病控制与预防中心通报,科罗拉多儿童医院对一组9名儿童进行了评估,这些儿童患有急性神经疾病,其特征为肢体无力、颅神经功能障碍(如复视、面部下垂、吞咽困难或构音障碍)或两者皆有。神经疾病发病时间在2014年8月8日至9月15日期间。这些儿童的中位年龄为8岁(范围为1至18岁)。除了一些患者有颈部、背部或肢体疼痛外,所有患者感觉均正常。所有患者在神经疾病发作前均有前驱发热性疾病,大多数伴有上呼吸道症状,发病时间在神经疾病发作前3至16天(中位值 = 7天)。在8名接受脊髓磁共振成像检查的患者中,有7名患者脊髓灰质出现多节段无强化病变,在9名接受脑部磁共振成像检查的患者中,有7名患者脑干出现无强化病变(最常见于脑桥背侧)。在5名接受腰骶部磁共振成像检查的患者中,有2名患者马尾神经腹侧神经根出现钆增强。8名儿童按时接种了脊髓灰质炎疫苗。8名儿童的神经功能尚未完全恢复。

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