Dr. von Hauner Children's Hospital, Ludwig-Maximilians University of Munich, Germany; Neuropediatric Department, Helios-Klinikum Hildesheim, Germany; Children's and Youth Hospital "Auf der Bult," Hannover, Germany; National Reference Center for Poliomyelitis and Enteroviruses, Robert Koch Institute, Berlin, Germany; German Center for Infection Research, Munich site, Germany.
Dtsch Arztebl Int. 2017 Aug 21;114(33-34):551-557. doi: 10.3238/arztebl.2017.0551.
Although poliomyelitis has almost been eradicated worldwide, cases of a polio-like disease with asymmetrical flaccid paralysis of variable severity have been seen repeatedly in recent years.
Data were collected on children treated in hospitals in the German federal states of Bavaria and Lower Saxony in 2016. The frequency of disease across Germany was estimated on the basis of voluntary reporting to the Robert Koch Institute. 16 cases were registered there for the entire year 2016.
7 children with flaccid paralysis of acute onset were treated in the participating hospitals in the summer and fall of 2016. We describe two illustrative cases, one with a mild course and one with a severe course. Rapid diagnosis requires not only clinical neurological assessment but also neurophysiological studies, magnetic resonance imaging (MRI), and targeted microbiological testing. The characteristic features include damage to the anterior horn of the spinal cord that can be seen on MRI and/or electrophysiologically demonstrable abnormalities indicating motor neuron damage. A pathogen can hardly ever be identified in the cerebrospinal fluid, but the epidemiological context and the detection of viruses in the stool or respiratory secretions indicate that entero - viruses may be responsible.
The prognosis of this disease cannot be reliably assessed at first, and no specific treatment is currently available.
虽然小儿麻痹症在全球范围内几乎已被根除，但近年来，反复出现了多例以不对称弛缓性瘫痪为特征、严重程度不一的类似小儿麻痹症的疾病。
本研究收集了 2016 年德国巴伐利亚州和下萨克森州医院治疗的患儿的数据。根据向罗伯特·科赫研究所的自愿报告，对德国各地的疾病频率进行了估计。2016 年全年共登记了 16 例病例。
2016 年夏秋季，参与医院共收治了 7 例急性起病的弛缓性瘫痪患儿。我们描述了两个有代表性的病例，其中 1 例为轻症，1 例为重症。快速诊断不仅需要临床神经学评估，还需要神经生理学研究、磁共振成像（MRI）和针对性的微生物学检测。特征性表现包括 MRI 可见的脊髓前角损伤和/或电生理学显示运动神经元损伤的异常。脑脊液中几乎无法检测到病原体，但流行病学背景和粪便或呼吸道分泌物中病毒的检出提示肠病毒可能是致病原因。
该病的预后最初无法可靠评估，目前尚无特效治疗方法。
