A Case of Polio-like Encephalomyelitis Associated with Enterovirus 71 Infection

ABSTRACT

Enterovirus 71(EV71), like polioviruses, invades the central nervous system to give rise to aseptic meningitis, encephalitis or myelitis. EV71 was first isolated in California in 1969 from a 9-month- old infant with encephalitis. Since then it has been isolated from the brain of children who died of encephalitis and from feces of patients with meningitis, encephalitis or paralysis. Related strains have been isolated from outbreaks of similar diseases in Australia, Sweden, Bulgaria and Hungary. We have experienced polio-like encephalomyelitis in a 3-month-old girl. Initial brain MR imaging showed tissue destruction in the bilateral posterior portions of the medulla oblongata and the bilateral anterior horns of cervical spinal cord from C3 to C6 level. Follow-up MR imaging was performed 3 months later, which showed minimal residual change on the anterior horn of the cervical spinal cord at C4 level only. This report deals with rare polio-like encephalomyelitis associated with EV71 and discusses its diagnosis and management. Brain stem and cervical spinal cord involvement are characteristic findings of EV encephalomyelitis.