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Flaccid paralysis

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https://www.readbyqxmd.com/read/28193112/longitudinal-outcomes-in-the-2014-acute-flaccid-paralysis-cluster-in-canada
#1
Carmen Yea, Ari Bitnun, Joan Robinson, Aleksandra Mineyko, Michelle Barton, Jean K Mah, Jiri Vajsar, Susan Richardson, Christoph Licht, Jason Brophy, Megan Crone, Shalini Desai, Juliette Hukin, Kevin Jones, Katherine Muir, Jeffrey M Pernica, Robert Pless, Daniela Pohl, Mubeen F Rafay, Kathryn Selby, Sunita Venkateswaran, Geneviève Bernard, E Ann Yeh
We describe the presenting features and long-term outcome of an unusual cluster of pediatric acute flaccid paralysis cases that occurred in Canada during the 2014 enterovirus D68 outbreak. Children (n = 25; median age 7.8 years) presenting to Canadian centers between July 1 and October 31, 2014, and who met diagnostic criteria for acute flaccid paralysis were evaluated retrospectively. The predominant presenting features included prodromal respiratory illness (n = 22), cerebrospinal fluid lymphocytic pleocytosis (n = 18), pain in neck/back (n = 14) and extremities (n = 10), bowel/bladder dysfunction (n = 9), focal central gray matter lesions found in all regions of the spinal cord within the cohort (n = 16), brain stem lesions (n = 8), and bulbar symptoms (n = 5)...
March 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28174033/acute-hypotonia-in-an-infant
#2
Jimme Sierakowski, Jason Arthur, Todd Wylie
BACKGROUND: Acute flaccid myelitis (AFM) is increasing in incidence in the United States and presenting to emergency departments (EDs) across the country. This clinical entity presents as acute paralysis, with magnetic resonance imaging changes in the gray matter only in children younger than 21 years of age. The etiology is unknown, although preceding viral illnesses are common. There are no consensus guidelines regarding treatment. CASE REPORT: A 4-month-old girl presented with decreased bilateral arm movement...
February 4, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28168168/enterovirus-71-infection-and-vaccines
#3
REVIEW
Eun-Je Yi, Yun-Ju Shin, Jeong-Hwan Kim, Tae-Gyun Kim, Sun-Young Chang
Hand, foot and mouth disease (HFMD) is a highly contagious viral infection affecting young children during the spring to fall seasons. Recently, serious outbreaks of HFMD were reported frequently in the Asia-Pacific region, including China and Korea. The symptoms of HFMD are usually mild, comprising fever, loss of appetite, and a rash with blisters, which do not need specific treatment. However, there are uncommon neurological or cardiac complications such as meningitis and acute flaccid paralysis that can be fatal...
January 2017: Clinical and Experimental Vaccine Research
https://www.readbyqxmd.com/read/28165146/enterovirus-d68-detection-in-respiratory-specimens-association-with-severe-disease
#4
I Engelmann, M Fatoux, M Lazrek, E K Alidjinou, A Mirand, C Henquell, A Dewilde, D Hober
Molecular techniques increased the number of documented respiratory infections. In a substantial number of cases the causative agent remains undetected. Since August 2014, an increase in Enterovirus(EV)-D68 infections was reported. We aimed to investigate epidemiology and clinical relevance of EV-D68. From June to December 2014 and from September to December 2015, 803 and 847 respiratory specimens, respectively, were tested for respiratory viruses with a multiplex RT-PCR. This multiplex RT-PCR does not detect EV-D68...
February 6, 2017: Journal of Medical Virology
https://www.readbyqxmd.com/read/28163843/outcome-of-guillain-barr%C3%A3-syndrome-in-children-a-prospective-cohort-study-in-a-tertiary-hospital-in-upper-egypt
#5
Abdelrahim Abdrabou Sadek, Ashraf Abou-Taleb, Wafaa Ahmed Ali
INTRODUCTION: Guillain-Barré syndrome is the most common cause of acute flaccid paralysis in children, and defined as an acute inflammatory polyneuropathy. The objective of this study was to assess the clinico-laboratory profile, and outcome of Guillain-Barré syndrome in children at Sohag University Hospital. METHODS: This prospective cohort observational study was conducted in 2014-2015. The included children were subjected to through medical history and detailed systemic and neurological examination...
December 2016: Electronic Physician
https://www.readbyqxmd.com/read/28161421/introduction-of-inactivated-poliovirus-vaccine-leading-into-the-polio-eradication-endgame-strategic-plan-hangzhou-china-2010-2014
#6
Yan Liu, Jun Wang, Shijun Liu, Jian Du, Liang Wang, Wenwen Gu, Yuyang Xu, Shuyan Zuo, Erping Xu, Zhijie An
BACKGROUND: China's Expanded Program on Immunization (EPI) has provided 4 doses of oral poliovirus vaccine (OPV) since the 1970s. Inactivated poliovirus vaccine (IPV) became available in 2010 in Hangzhou as a private-sector, parent-chosen alternative to OPV. In 2015, WHO recommended that countries with all-OPV vaccination schedules introduce at least one dose of IPV, to mitigate risk associated with the withdrawal of type 2 OPV. We analyzed polio vaccine coverage and utilization in Hangzhou to determine patterns of IPV use and the occurrence of vaccine-associated paralytic polio (VAPP) in the various patterns identified...
February 1, 2017: Vaccine
https://www.readbyqxmd.com/read/28161374/chronic-gabaergic-blockade-in-the-spinal-cord-in%C3%A2-vivo-induces-motor-alterations-and-neurodegeneration
#7
Uri Nimrod Ramírez-Jarquín, Ricardo Tapia
Inhibitory GABAergic and glycinergic neurotransmission in the spinal cord play a central role in the regulation of neuronal excitability, by maintaining a balance with the glutamate-mediated excitatory transmission. Glutamatergic agonists infusion in the spinal cord induce motor neuron death by excitotoxicity, leading to motor deficits and paralysis, but little is known on the effect of the blockade of inhibitory transmission. In this work we studied the effects of GABAergic and glycinergic blockade, by means of microdialysis perfusion (acute administration) and osmotic minipumps infusion (chronic administration) of GABA and glycine receptors antagonists directly in the lumbar spinal cord...
February 1, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28103209/west-nile-virus-and-other-nationally-notifiable-arboviral-diseases-united-states-2015
#8
Elisabeth Krow-Lucal, Nicole P Lindsey, Jennifer Lehman, Marc Fischer, J Erin Staples
Arthropod-borne viruses (arboviruses) are transmitted to humans primarily through the bites of infected mosquitoes and ticks. The leading cause of domestically acquired arboviral disease in the United States is West Nile virus (WNV) (1). Other arboviruses, including La Crosse, St. Louis encephalitis, Jamestown Canyon, Powassan, and eastern equine encephalitis viruses, also cause sporadic cases and outbreaks. This report summarizes surveillance data reported to CDC in 2015 for nationally notifiable arboviruses...
January 20, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28095134/physical-and-occupational-therapy-for-a-teenager-with-acute-flaccid-myelitis-a-case-report
#9
Tracy Kornafel, Elaine Y Tsao, Emily Sabelhaus, Lori Surges, Susan D Apkon
AIMS: The purpose of this case report is to describe the inpatient rehabilitation program of a 13-year-old boy with acute flaccid myelitis (AFM), specific to physical and occupational therapy examination, treatment, and outcomes. CASE DESCRIPTION: AFM is a rare, acute neurologic illness in children and young adults who present with weakness and/or paralysis of unknown etiology. The teenager was admitted to the program, dependent for all mobility and self-care. Interventions focused on range of motion, transfer training, self-care, power wheelchair mobility, and environmental adaptations...
January 17, 2017: Physical & Occupational Therapy in Pediatrics
https://www.readbyqxmd.com/read/28094079/a-stroke-mimic-methotrexate-induced-neurotoxicity-in-the-emergency-department
#10
Patrick Rogers, Wilbur J Pan, Richard A Drachtman, Christopher Haines
BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common form of childhood leukemia. The treatment of ALL involves multimodality therapy, and methotrexate (MTX) remains a mainstay of treatment. A complication of MTX therapy includes acute, subacute, and chronic neurotoxocity. Signs and symptoms may range from headaches, dizziness, and mood disorders to seizures and stroke-like symptoms. CASE REPORT: An 18-year-old woman with a history of ALL presented to the emergency department with acute onset of right-sided facial paralysis, right upper extremity flaccid paralysis, and right lower extremity weakness after receiving MTX therapy 3 days earlier...
January 13, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28079273/abnormal-fetal-muscle-forces-result-in-defects-in-spinal-curvature-and-alterations-in-vertebral-segmentation-and-shape
#11
Rebecca A Rolfe, James H Bezer, Tyler Kim, Ahmed Z Zaidon, Michelle L Oyen, James C Iatridis, Niamh C Nowlan
The incidence of congenital spine deformities, including congenital scoliosis, kyphosis and lordosis, may be influenced by the in utero mechanical environment, and particularly by fetal movements at critical time-points. There is a limited understanding of the influence of fetal movements on spinal development, despite the fact that mechanical forces have been shown to play an essential role in skeletal development of the limb. This study investigates the effects of muscle forces on spinal curvature, vertebral segmentation and vertebral shape by inducing rigid or flaccid paralysis in the embryonic chick...
January 12, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28071799/seroepidemiological-and-phylogenetic-characterisation-of-neurotropic-enteroviruses-in-ireland-2005-2014
#12
Jorge Abboud Guerra, Allison Waters, Alison Kelly, Ursula Morley, Paul O'Reilly, Edwin O'Kelly, Jonathan Dean, Robert Cunney, Piaras O'Lorcain, Suzanne Cotter, Jeff Connell, Joanne O'Gorman, William W Hall, Michael Carr, Cillian F De Gascun
Enteroviruses (EVs) are associated with a broad spectrum of clinical presentation, including aseptic meningitis (AM), encephalitis, hand, foot and mouth disease, acute flaccid paralysis and acute flaccid myelitis. Epidemics occur sporadically and are associated with increased cases of AM in children. The present study describes the seroepidemiological analysis of circulating EVs in Ireland from 2005-2014 and phylogenetic characterisation of echovirus 30 (E-30), enterovirus A71 (EV-A71) and enterovirus D68 (EV-D68)...
January 10, 2017: Journal of Medical Virology
https://www.readbyqxmd.com/read/28062435/flaccid-paralysis-in-an-infant-associated-with-a-dirty-wound-and-application-of-honey
#13
Charlotte Jane Joseph, Teik Beng Khoo, Keng Yee Lee
An infant, who was born preterm at 36 weeks, presented with fever and ulcer at umbilical region which progressed to necrotising fasciitis of anterior abdominal wall. He was treated with intravenous penicillin, intravenous cloxacillin and local application of medicated honey. Subsequently, he required wound debridement. Postoperatively, he required prolonged invasive ventilation due to poor respiratory effort which was associated with hypotonia and areflexia. Nerve conduction study revealed absent responses...
January 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28061751/evolutionary-phylogeography-and-transmission-pattern-of-echovirus-14-an-exploration-of-spatiotemporal-dynamics-based-on-the-26-year-acute-flaccid-paralysis-surveillance-in-shandong-china
#14
Peng Chen, Yan Li, Zexin Tao, Haiyan Wang, Xiaojuan Lin, Yao Liu, Suting Wang, Nan Zhou, Pei Wang, Aiqiang Xu
BACKGROUND: Echovirus 14 (E-14) causes various clinical recognized syndromes, mostly with gastrointestinal syndrome and paralysis. The current study summarized the Shandong E-14 strains isolated from a 26-year acute flaccid paralysis (AFP) surveillance, and elucidated the characterization of phylogenetic and phylogeographic relationships of E-14 worldwide. RESULTS: As a predominant serotype circulating in AFP surveillance, phylogenetic analysis showed that E-14 exhibited both time and geographic subdivision worldwide...
January 7, 2017: BMC Genomics
https://www.readbyqxmd.com/read/28056277/-direct-medical-costs-and-influencing-factors-in-severe-hand-foot-and-mouth-disease-in-children-aged-between-six-months-and-five-years-old
#15
Y M Zheng, J Yang, Q H Liao
Objective: To estimate the direct medical cost of severe hand, foot and mouth disease (HFMD) in patients aged less than five years. Methods: A stratified sampling method was used to collect data on severe HFMD cases reported in the National HFMD surveillance database between Jan 1, 2012, and Dec 31, 2013. The sampling was referenced with the national aetiologic distribution of Enterovirus A71 (EV-A71), Coxsackievirus A16 (CV-A16) and other Enteroviruses (OEV) for severe HFMD cases and the included cases were distributed among seven geographic regions (Northeast, North China, Northwest, Central China, Southwest, East China and South China)...
January 6, 2017: Zhonghua Yu Fang Yi Xue za Zhi [Chinese Journal of Preventive Medicine]
https://www.readbyqxmd.com/read/28053366/acute-flaccid-paralysis-incidence-and-zika-virus-surveillance-pacific-islands
#16
Adam T Craig, Michelle T Butler, Roberta Pastore, Beverley J Paterson, David N Durrheim
PROBLEM: The emergence of Zika virus has challenged outbreak surveillance systems in many at-risk, low-resource countries. As the virus has been linked with Guillain-Barré syndrome, routine data on the incidence of acute flaccid paralysis (AFP) may provide a useful early warning system for the emergence of Zika virus. APPROACH: We documented all Zika virus outbreaks and cases in 21 Pacific Islands and territories for the years 2007 to 2015. We extracted data from the Global Polio Eradication Initiative database on the reported and expected annual incidence of AFP in children younger than 15 years...
January 1, 2017: Bulletin of the World Health Organization
https://www.readbyqxmd.com/read/28017237/serum-antibodies-targeting-neurons-of-the-monoaminergic-systems-in-guillain-barr%C3%A3-syndrome
#17
Claudia Rink, Angelika Görtzen, Rüdiger W Veh, Harald Prüss
Guillain-Barré syndrome (GBS) is an autoimmune disease with progressive flaccid paralysis of the extremities. Several auto-antibodies have been identified, binding to myelin, gangliosides, astrocytes or proteins at the nodes of Ranvier. Some epitopes are not confined to the peripheral nerve, suggesting that auto-antibodies may also contribute to symptoms of the central nervous system, which are common in GBS and include anxiety, depression, hallucinations, oneiroid psychosis or fatigue. This notion is supported by treating patients with plasma exchange, resulting in improvement of both central and peripheral symptoms...
January 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28011278/molecular-characterization-of-echovirus-13-uncovering-high-genetic-diversity-and-identification-of-new-genotypes-in-pakistan
#18
Shahzad Shaukat, Mehar Angez, Tariq Mahmood, Muhammad Masroor Alam, Salmaan Sharif, Adnan Khurshid, Muhammad Suleman Rana, Syed Sohail Zahoor Zaidi
Echovirus 13 (E-13) is reported worldwide and is mostly related to aseptic meningitis but it is also isolated from cases of acute flaccid paralysis (AFP). Unfortunately, all studies conducted on non polio enterovirus in Pakistan only confirm E-13 isolation based on microneutralization assay but there is lack of molecular epidemiological data on this serotype. In this study, 113 stool samples were collected from AFP patients during 2008-2010. An enterovirus primer mediated real-time reverse transcriptase polymerase chain reaction, a standard microneutralization assay and sequencing of viral protein 1 gene (VP1) identified the predominant serotype E-13...
December 20, 2016: Infection, Genetics and Evolution
https://www.readbyqxmd.com/read/28000111/uncommon-disorders-masquerading-as-acute-flaccid-paralysis-in-children
#19
Meenal Garg, Shilpa D Kulkarni, Varsha Patil, Rafat Sayed, Anaita Udwadia Hegde
The syndrome of acute flaccid paralysis (AFP) is a common medical emergency in children. In the era of poliomyelitis eradication, the common causes of AFP include Guillain-Barré syndrome (GBS), transverse myelitis and traumatic neuritis. However, many common diseases can uncommonly present as AFP and some uncommon diseases may also masquerade like it. Uncommon causes of AFP seen at a tertiary care pediatric hospital are discussed along with relevant points in diagnosis and management. Also, common pitfalls in diagnosis of pediatric AFP and an approach to investigations are discussed...
December 21, 2016: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/27994894/ischemic-monomeric-neuropathy-in-a-woman-with-sickle-cell-anaemia
#20
Alexandra Agapidou, Laura Aiken, Lisa Linpower, Dimitris A Tsitsikas
Sickle cell disease is an inherited haemoglobinopathy that can affect multiple organs and systems. The most common neurological complication in sickle cell disease is stroke and silent cerebral infarcts. Peripheral nervous system involvement has been described but is exceedingly rare. Herein, we describe the case of a young woman who presented with acute flaccid paralysis and sensory loss of the left lower extremity in the context of a painful vasoocclusive crisis which resolved rapidly after receiving an emergency automated red cell exchange transfusion...
2016: Case Reports in Hematology
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