title: Clinical and neuroimaging features of enterovirus71 related acute flaccid paralysis in patients with hand-foot-mouth disease.
abstract: OBJECTIVE
  To investigate clinical and neuroimaging features of enterovirus71 (EV71) related acute flaccid paralysis in patients with hand-foot-mouth disease.
  
  
  METHODS
  Nine patients with acute flaccid paralysis met the criterion of EV71 induced hand-foot-mouth disease underwent spinal and brain MR imaging from May 2008 to Sep 2012.
  
  
  RESULTS
  One extremity flaccid was found in four cases (3 with lower limb, 1 with upper limb), two limbs flaccid in three cases (2 with lower limbs, 1 with upper limbs), and four limbs flaccid in two cases. Spinal MRI studies showed lesion with high signal in T2-weighted images (T2WI) and low signal T1-weighted images (T1WI) in the spinal cord of all nine cases, and the lesions were mainly in bilateral and unilateral anterior horn of cervical spinal cord and spinal cord below thoracic 9 (T9) level. In addition, the midbrain, pons, and medulla, which were involved in 3 cases with brainstem encephalitis, demonstrated abnormal signal. Moreover, spinal cord contrast MRI studies showed mild enhancement in corresponding anterior horn of the involved side, and strong enhancement in its ventral root.
  
  
  CONCLUSIONS
  EV71 related acute flaccid paralysis in patients with hand-foot-mouth disease mainly affected the anterior horn regions and ventral root of cervical spinal cord and spinal cord below T9 level. MR imaging could efficiently show the characteristic pattern and extent of the lesions which correlated well with the clinical features.
authors: Department of Radiology, People's Hospital of Hainan Province, Haikou, PR China.
authors: Feng
authors: F
authors: Chen
authors: Jian-Jun
authors: JJ
authors: Li
authors: Tao
authors: T
authors: Liu
authors: Guo-Qiang
authors: GQ
authors: Wen
authors: Wei
authors: W
authors: Xiang
mesh_terms: D001921:Brain / Q000473:pathology; D002675:Child, Preschool; D029821:Enterovirus A, Human / Q000302:isolation & purification*; D005260:Female; D006232:Hand, Foot and Mouth Disease / Q000175:diagnosis* / Q000503:physiopathology / Q000821:virology; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D010243:Paralysis / Q000175:diagnosis* / Q000503:physiopathology / Q000821:virology*; D013116:Spinal Cord / Q000473:pathology