RT Journal Article
SR Electronic
T1 Acute segmental poliomyelitis-like flaccid paralysis in an adult in the UK, associated with enterovirus D68
JF Practical Neurology
JO Pract Neurol
FD BMJ Publishing Group Ltd
SP 297
OP 301
DO 10.1136/practneurol-2017-001609
VO 17
IS 4
A1 Sybil R L Stacpoole
A1 Adam Molyneux
A1 Dirk Bäumer
YR 2017
UL http://pn.bmj.com/content/17/4/297.abstract
AB Enterovirus D68 has been associated with a poliomyelitis-like illness, notably during an outbreak in 2014, and particularly affecting children in the USA. We report a case of acute segmental flaccid paralysis with respiratory involvement in an adult in the UK, with enterovirus D68 detected in a sputum sample. MR imaging of cervical spinal cord showed a longitudinally extensive T2 hyperintensity in the anterior cord. Cerebrospinal fluid showed an elevated white cell count, predominantly lymphocytic, with otherwise normal constituents and negative viral PCRs. His respiratory function improved after intravenous immunoglobulin, suggesting that this may be useful in such cases. Clinicians should consider enterovirus D68 infection in the differential diagnosis of Guillain-Barré syndrome, particularly the pharyngeal–cervical–brachial variant.