Distinct Syndrome of Acute Flaccid Paralysis Identified

Clinical manifestations indicate syndrome of flaccid paralysis with spinal motor neuron involvement

a child on a wheelchair

TUESDAY, Dec. 22, 2015 (HealthDay News) -- Acute flaccid paralysis with evidence of spinal motor neuron involvement represents a unique syndrome, according to research published in the Dec. 22/29 issue of the Journal of the American Medical Association.

Keith Van Haren, M.D., from the Stanford University School of Medicine in California, and colleagues quantified disease incidence and identified potential etiologies of acute flaccid paralysis cases with evidence of spinal motor neuron injury. Patients reported to the California Department of Public Health, with symptom onset between June 2012 and July 2015, were identified.

The researchers identified 59 cases, with a median age of 9 years (50 cases were younger than 21 years). Respiratory and gastrointestinal illness, fever, and limb myalgia preceded or were concurrent with incidence (54, 47, and 41 patients, respectively). On magnetic resonance imaging, 56 patients had T2 hyperintensity of spinal gray matter and 43 patients had cerebrospinal fluid pleocytosis. At nine-month follow-up, 38 of the 45 patients with follow-up data had persistent weakness. Two patients died within 60 days of symptom onset, both immunocompromised adults. Enteroviruses were the most frequently detected pathogen (15 of 45 patients tested). During a national enterovirus D68 outbreak, the incidence of reported cases was significantly higher (P < 0.001).

"The etiology remains undetermined, most patients were children and young adults, and motor weakness was prolonged," the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.

Abstract
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