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Neuropediatrics 2014; 45(02): 102-108
DOI: 10.1055/s-0033-1360480
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Neurological Images and the Predictors for Neurological Sequelae of Epidemic Herpangina/Hand-Foot-Mouth Disease with Encephalomyelitis

Jeng-Dau Tsai
1   Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
2   Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
,
Hung-Tsung Kuo
3   Department of Pediatrics, China Medical University Hospital, Taichung, Taiwan
,
Shan-Ming Chen
1   Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
2   Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
,
Ko-Huang Lue
1   Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
2   Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
,
Ji-Nan Sheu
2   Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
4   School of Medicine, Chung Shan Medical University, Taichung, Taiwan
› Author Affiliations
Further Information

Publication History

04 February 2013

23 August 2013

Publication Date:
20 November 2013 (online)

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Abstract

Since 1998 in Taiwan, enterovirus (EV) 71 epidemics have caused encephalomyelitis and placed a significant burden on parents and physicians. In this study, we present clinical manifestations, magnetic resonance (MR) imaging findings, and neurological sequelae on epidemic EV-infected patients with encephalomyelitis. Of the 46 patients, 14 patients presented with neurological sequelae; of them, 3 patients suffered from complications of mental regression. Predictors of unfavorable neurological sequelae were myoclonic jerks (> 4 times/night) and pleocytosis (167/μL) of the cerebrospinal fluid (CSF). Results from viral culture and MR imaging indicated that positive identification of EV71 infection was associated significantly with lesions on MR imaging. Our results show that hand-foot-mouth disease carries a higher risk of encephalomyelitis and that frequent myoclonic jerks and pleocytosis of the CSF are risk factors for subsequent neurological sequelae. Positive identification of EV71 might be useful as a predictor of lesions in MR imaging.

Keywords

enterovirus 71 - neurological images - predictors - neurological sequelae - Taiwan

Ethical Approval

The Institutional Review Board of the Chung Shan Medical Hospital and China Medical University Hospital approved the study and the parents of all the participants provided informed consent.


 

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