Department of Biomedical Sciences for Health, University of Milan, Via Pascal 36, 20133, Milan, Italy.
Unit of Child Neurology and Psychiatry, ASST Spedali Civili, Brescia, Italy.
J Neurovirol. 2018 Oct;24(5):656-659. doi: 10.1007/s13365-018-0656-y. Epub 2018 Jul 11.
A previously healthy 6-year-old boy was admitted to hospital with hypotonia and hyposthenia of lower limbs. Electromyography and slow motor nerve conduction velocity test identified a lower limb acute motor axonal neuropathy. Brain and spinal cord magnetic resonance imaging demonstrated multifocal cortical gray matter lesions in both cerebral hemispheres consistent with gray matter acute disseminated encephalitis otherwise with viral/Mycoplasma pneumoniae encephalitis, and signs of involvement of anterior nerve roots of the cauda equina consistent with Guillain-Barré syndrome. The patient resulted negative to routinely bacterial and viral investigations but positive to human parechovirus that sequence analyses confirmed as type 6. Intravenous immunoglobulins and methylprednisolone treatment were administered but did not relieve the symptoms of Guillain-Barré syndrome. The disease improved gradually over the next 3-month follow-up with a complete remission of both central and peripheral nervous system symptoms.
一位原本健康的 6 岁男孩因下肢弛缓性瘫痪和无力而入院。肌电图和运动神经传导速度缓慢检测提示急性运动轴索性神经病。脑和脊髓磁共振成像显示双侧大脑半球多灶性皮质灰质病变，符合灰质急性播散性脑炎，也可能是病毒性/肺炎支原体脑炎，并伴有马尾神经根受累的迹象，符合格林-巴利综合征。该患者常规细菌和病毒检查均为阴性，但人副肠孤病毒检测为阳性，序列分析证实为人副肠孤病毒 6 型。给予静脉注射免疫球蛋白和甲基强的松龙治疗，但未能缓解格林-巴利综合征的症状。在接下来的 3 个月随访中，疾病逐渐改善，中枢和周围神经系统症状完全缓解。
