title: Isolated polio-like syndrome after tick-borne encephalitis presenting with acute hyperckemia.
abstract: Tick borne encephalitis virus infection usually shows a biphasic course. In the first stage of illness symptoms are similar to a flu-like syndrome, then after a defervescence period, fever may represent with neurological manifestations ranging from mild meningitis to severe encephalomyelitis. We report the clinical case of an adult man presented with an acute proximal hyposthenia, severe hyperckemia, clinical and laboratoristic evidence of acute tick borne virus infection. This virus has a favourite tropism for the anterior horn cells of the cervical spine segment. Polio-like syndrome, usually affecting the upper limbs, is the clinical phenotype of an infection of the cervical motoneurons. Usually myelitis is associated to severe encephalitis and a complete diagnosis may be difficult in comatose patients. Rarely, an isolated polio-like syndrome may be the sole neurological complication of tick-borne encephalitis.
authors: Department of Neurology, Ospedale San Martino Belluno, Viale Europa 22, 32100, Belluno, Italy. sandro.zambito@ulss.belluno.it
authors: Sandro
authors: S
authors: Zambito Marsala
authors: Ermenegildo
authors: E
authors: Francavilla
authors: Manuela
authors: M
authors: Gioulis
authors: Rosa Maria
authors: RM
authors: Candeago
authors: Valeria
authors: V
authors: Mondardini
authors: Manrico
authors: M
authors: Gentile
authors: Franco
authors: F
authors: Ferracci
authors: Francesco
authors: F
authors: Guzzo
authors: Carmela
authors: C
authors: Granata
authors: Corrado
authors: C
authors: Marchini
mesh_terms: D000208:Acute Disease; D003402:Creatine Kinase / Q000097:blood*; D004576:Electromyography; D004675:Encephalitis, Tick-Borne / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology; D011051:Poliomyelitis / Q000175:diagnosis / Q000209:etiology*
chemical_list: D003402:Creatine Kinase