急性弛缓性脊髓炎-印度南部三级保健中心类似脊灰样疾病聚集性病例。
Acute flaccid myelitis-Clustering of polio-like illness in the tertiary care centre in Southern India.
机构信息
Postdoctoral Fellow, Department of Paediatric Neurology, Indira Gandhi Institute of Child Health, Bengaluru, India.
Associate Professor, Department of Paediatric Neurology, Indira Gandhi Institute of Child Health, Bengaluru, India.
出版信息
J Trop Pediatr. 2019 Aug 1;65(4):309-314. doi: 10.1093/tropej/fmy052.
INTRODUCTION
Acute flaccid myelitis (AFM) is characterized by limb weakness with spinal cord grey matter lesion on imaging or electrodiagnostic evidence of spinal cord motor neuron injury. This Poliomyelitis-like illness is rare in children, and its natural course is not yet well defined.
PURPOSE OF THE STUDY
The purpose of the study was to report the clinical presentation, laboratory findings, management and outcome of children with AFM.
MATERIALS AND METHODS
This is a prospective case series study.
RESULTS
Nine children met the case definition given by CDC. All cases presented with prodromal symptoms followed by acute onset asymmetrical limb weakness. Maximum weakness is reached within 4 days from the day of onset. Cerebrospinal fluid analysis shows that pleocytosis with viral markers for arboviruses and enteroviruses was negative. Electrophysiological study revealed decreased muscle action potential in all. MRI of the spinal cord showed predominantly grey matter involvement.
CONCLUSION
AFM should be one of the differential diagnoses in any child presenting with acute flaccid paralysis.
简介
急性弛缓性脊髓炎（AFM）的特征是肢体无力，影像学表现为脊髓灰质病变，或电诊断证据显示脊髓运动神经元损伤。这种类似脊髓灰质炎的疾病在儿童中较为罕见，其自然病程尚不完全明确。
研究目的
本研究旨在报告 AFM 患儿的临床表现、实验室检查结果、治疗方法和转归。
材料和方法
这是一项前瞻性病例系列研究。
结果
9 例患儿符合 CDC 的病例定义。所有病例均有前驱症状，随后出现急性非对称性肢体无力。最大肌力在发病后 4 天内达到。脑脊液分析显示细胞增多，伴有虫媒病毒和肠道病毒的病毒标志物均为阴性。电生理研究显示所有患儿的肌肉动作电位均降低。脊髓 MRI 显示主要为灰质受累。
结论
任何出现急性弛缓性瘫痪的儿童，AFM 均应作为鉴别诊断之一。
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