[A case of measles encephaloneuropathy in a pregnant women].
We reported a patient with measles encephaloneuropathy. A 26-year-old woman in her 15th week of gestation became febrile and developed cutaneous eruption typical of measles on July 1 1997. Five days after appearance of the rash, fetal death was identified and the fetus was removed. Following the operation, she became comatous. Neurological examination revealed neck stiffness, flaccid paralysis of the four limbs, and decreased sweating in the lower limbs. CSF protein was 143 mg/dl with cell count of 1365/mm3. Myelin basic protein in CSF was positive. High titers of antimeasles antibodies were found in the serum and the cerebrospinal fluid. EEG revealed a predominance of slow waves. In MRI obtained earlier in her illness, high signal intensity areas were noted to spread in the brain stem and external capsule on T2-weighted images. However, T1-weighted image was unremarkable. Serial electrophysiological studies suggested demyelination of the motor nerves. With combination of methylprednisolone and immunoglobulin therapy, she made a remarkable recovery without any neurologic sequelae. We believe that the measles encephalitis in our patient is predominantly demyelinating due to an immunologic reaction in a pathophysiological aspect. We should pay attention to coincident poly-radiculoneuropathy in the early stage of measles encephalopathy.
Department of Neurology, Kochi Prefectural Central Hospital, Japan.
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Haraguchi
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Yabuki
D000328:Adult; D004576:Electromyography; D018792:Encephalitis, Viral / Q000209:etiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008457:Measles / Q000209:etiology*; D011129:Polyradiculoneuropathy / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011262:Pregnancy Trimester, Second