Yoshimura K, Kurashige T
Department of Pediatrics, Tosa Municipal Hospital, Kochi, Japan.
Brain Dev. 1998 Oct;20(7):540-2. doi: 10.1016/s0387-7604(98)00050-3.
The authors report the case of a boy aged 4 years who had sudden abdominal pain and inability to walk on the day before admission to hospital and who developed abdominal distention and difficulty urinating. On admission, the abdominal skin reflexes, knee jerks, cremaster and anal reflexes were absent and power in the lower extremities was reduced. Spinal fluid examination showed a cell count of 383/mm3, with 95% neutrophils and 5% lymphocytes; spinal fluid protein of 44 mg/dl; and glucose 75 mg/dl. Serological studies did not reveal any significant antibodies for polio virus type 1, 2, 3, various ECHO viruses, Coxsackie types A4, A7, A9, B1 or B5. However, the titer of Coxsackie virus antibody type A10 was 128 in the acute phase and only 32 in the recovery phase 4 weeks later. Magnetic resonance scans were performed on the second day; the findings were normal in the brain, but interesting lesions were revealed in the thoracic cord with both T1-weighted images and T2-weighted images. Neurological symptoms improved asymmetrically.
作者报告了一名4岁男孩的病例，该男孩在入院前一天突然出现腹痛且无法行走，随后出现腹胀和排尿困难。入院时，腹部皮肤反射、膝反射、提睾反射和肛门反射消失，下肢肌力减弱。脑脊液检查显示细胞计数为383/mm³，其中95%为中性粒细胞，5%为淋巴细胞；脑脊液蛋白为44mg/dl；葡萄糖为75mg/dl。血清学研究未发现针对1型、2型、3型脊髓灰质炎病毒、各种埃可病毒、A4型、A7型、A9型、B1型或B5型柯萨奇病毒的任何显著抗体。然而，A10型柯萨奇病毒抗体滴度在急性期为128，4周后的恢复期仅为32。第二天进行了磁共振扫描；脑部检查结果正常，但在胸段脊髓的T1加权图像和T2加权图像上均发现了有趣的病变。神经症状呈不对称改善。
