Clinical and neuroelectrophysiological characteristics of 32 children with poliomyelitis syndrome / 重庆医科大学学报

ABSTRACT

Objective:To analyze the clinical characteristics,neuroelectrophysiological changes and prognosis in children with Acute Flaccid Paralysis(AFP) caused by non-poliovirus(NPV) infections,and to explore it’s possible pathogenesis. Methods: Clinical observation,EV-antibody(EV-Ab) detection in blood serum,creatase detection in blood serum,cerebrospinal fluid(CSF) check-up and electrophysiologic study(EPS) were done in 32 AFP cases by NPV infections;and the result were compared. Results:(1)Children at every age were involved,mostly at age of 1~3 years;it occurred in every season,mostly in summer and autumn;Before palsy,most of them were affected by viral infections in respiratory tract or digestive tract;29 cases had AFP in one side of lower extremity with 3~4 grade muscle force,only 3 cases presented dissymmetrical AFP in both lower extremities,all cases had weakened tendon reflex,and none had sensory disorder.(2)Of 32 cases,10 presented Coxsackie virus antibody(CBV-IgM)(+) and 12 ECHOV-IgM(+) in blood serum,2 presented CBV-IgM(+) and slightly increased protein in CSF,and the rest were normal;2 cases had slightly increased CK in blood serum during climax,and presented normal in convalescent period. (3)Electrophysiologic changes included the following 29 cases had cutdowned compound muscle action potential(CMAP) wave amplitude in motor nerves,especially in the distal amplitude,even disappeared,and had normal nerve conduction velocity(NCV) in motor nerves,the present rate of F-wave was decreased,all cases had normal sensory nerve action potential(SNAP),and normal sensory nerve conduction velocity(SCV),electromyogram of 26 cases indicated neurogenic lesion,and only 3 cases had no obvious changes.(4)Majority of 32 cases recovered in two weeks,and the prognosis was good. Conclusion:The possible mechanism of AFP in children with NPV infections is that the induced immune reaction from NPV infections leaded to the motor nerve’s axonal slight degeneration,especially in its distal amplitude.