To describe the unique neuroimaging findings ocurring during an enterovirus A71 (EV-A71) outbreak in Madrid,
Enteroviruses are members of the picornavirusfamily,
a large and diverse group of small RNAvirusescharacterized by a single positive-strand genomic RNA.
Serotype A71 (EV-A71) infection may be asymptomatic but it is also known as a significant cause of hand,
foot and mouth disease (HFMD),
herpangina and respiratory infections.
in rare cases infection may be followed by severe neurological infection resulting in brainstem encephalitis and even acute flacid paralysis (AFP) a “polio...
Findings and procedure details
Our patients typically showed rombencephalitis affecting the posterior pons and,
in a lesser extent,
the medula oblongata and midbrain.Only two cases showed changes in the spinal cord. All 7 patients presented a febrile syndrome and decreased level of consciousness and drowsiness that reflect encephalitis symptoms.One patient also presented seizures,
and two other had manifestations of acute flaccid paralysis.
Our oldest patients (three children of 22,
29 and 36 months old) presented central...
Rhombencephalitis have been docummented as an uncommon complication of EV-71 infections.
In these cases,
characteristic hyperintense lesions in the brain stem may be identified on MRI,
specially in the dorsal pons and in the dentate nuclei. Spinal cord lesions are less common and usually appear like large diffuse lesions involving the central gray matter. Recognition of these findings in the presence of suggestive clinical presentation can help to establish the diagnosis of enterovirus...
Maloney et al.MRI Findings in Children with Acute Flaccid Paralysis andCranial Nerve Dysfunction Occurring during the 2014 Enterovirus D68 Outbreak.AJNR Am J Neuroradiol.
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