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A Clinical Study on Aseptic Meningitis Combined with Polio-Like Paralysis

Journal of the Korean Pediatric Society 1993;36(4):485-494.
Published online April 15, 1993.
A Clinical Study on Aseptic Meningitis Combined with Polio-Like Paralysis
Woong Young Moon1, Ki Soo Kim1, Young Seo Park1, Hyung Nam Moon1, Chang Yee Hong1, Dae Chul Suh2, Si Joon Yu3, In Young Seong3, Young Min Ahn4
1Department of Pediatrics, College of Medicine, University of Ulsan, Seoul, Korea
2Department of Radiology, College of Medicine, University of Ulsan, Seoul, Korea
3Department of Rehabilitation, College of Medicine, University of Ulsan, Seoul, Korea
4Department of Pediatrics, Kangnam General Hospital, Seoul, Korea
운동마비가 합병된 무균성 뇌막염에 관한 임상적 고찰
문웅영1, 김기수1, 박영서1, 문형남1, 홍창의1, 서대철2, 유시준3, 성인영3, 안영민4
1울산대학교 의과대학 소아과
2울산대학교 의과대학 진단방사선과
3울산대학교 의과대학 재활의학과
4강남시립병원 소아과
We clinically reviewed four patients who were suffering from aseptic meningitis combined with polio-like paralysis and performed radiological, neurological and virological studies on them. Three patients were admitted to the department of Pediatrics. Asan Medical Center from March to August 1990, and one patient was admitted to the department of Pediatrics, Kangnam General Hospital. The results were as follows: 1) During the period of study, 18 patients(10.1%) our of 178 aseptic meningitis patients also suffered from hand, foot and mouth disease, and three patients(1.69%) out of 178 patients also suffering from polio-like paralysis. 2) The age of the patients who also suffered from polio-like paralysis were eight months, 22 months, 23months and four years old respectively. Three patients were male and one patient was female. 3) Paralysis developed three to five days after asepitc meningitis infection. 4) In two cases, Magnetic Resonance Imaging(MR) showed two small cavitary lesions that means anterior horn cell necrosis in concordant with residual paralysis. Axial T1-weighted image showed decreased signal intensity and axial t2-weighted image showed increased signal intensity. In another case 20 days after onset of illness MR was performed, the transverse myelitis showed mild swelling of cornus medullaris. Follow up MR in 2months revealed atropic change in lower thoracic spinal cord. 5) The electromyography and nerve conduction velocity test revealed acute polyradiculoneuropathy. 6) Serologic virus study were carried out in three cases for Coxsackievirus A16 and Enterovirus A16 and Enterovirus 71. The Enterovirus 71 antibody titer were less than 1:4. This study showed that the causative agents for polio-like paralysis during this period seemed to be the Enterovirus 71 infection.
Key Words: Aseptic meningitis, Polio-like paralysis, Enterovirus 71, Magnetic Resornance imaging

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