Acute flaccid paralysis in hand-foot-mouth disease with enterovirus 71 infection:MR imaging findings and clinical correlations

REN Qing-yun; HE Li; LIU Zhai; WANG Wei-xiu

Abstract：Objective To explore the features of clinical manifestations and spinal MR images of acute flaccid paralysis associated with enterovirus 71 infected hand-foot-mouth disease (HFMD) .Methods Clinical characteristics and MRI fea-ture of 13 children with EV 71 combined myelitis were retrospectively reviewed .Results Acute paralysis was observed in unilateral lower limb in 6 of 13 patients ,in both lower limb in 2 patients ,in unilateral upper limb in 2 patients ,in unilater-al upper and louwer limb in 1 patient ,in both upper limb in 1 patient ,in the left upper limb and right lower limb in 1 pa-tient .MR studies showed the hypointensity or isointensity on T1WI and hyperintensity on T2WI in the anterior horn re-gions of the spinal cord on sagital and transwers image ,the lesions at the anterior horn level in the lower thoracic to lum-bosacral segment of the cord were seen in 8 patients ,the lesions in the cervical segment of the cord were seen in 5 patients . Of the 13 patents ,1 showed unilateral anterior horn regions lesions ,12 showed bilateral lesions .Four of five patents with cervical lesions combined with brainstem encephalitis ,the lesion of brainstem lied at the bondary of medulla oblongata and pond .MR imaging finding of EV71 myelitis and its clinical manifestations had good correlation .Conclusion MRI is the preferential choice for the diagnosis of EV71 combined acute flaccid paralysis ,It can provide reliable imaging imfomation for physicion .The leasions tends to be in lower thoracic to lumbersacral segment and cervical segment of the cord and spe-cifically involves the anterior of the cord .