Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of severe acute flaccid myelitis requiring continuous mechanical ventilation

Kinya Matsuo, M.D.1)2), Michiaki Koga, M.D.2), Masahiro Shiraishi, M.D.3), Masanari Hasegawa, M.D.3), Takashi Kanda, M.D.2) and Toshihiro Fukusako, M.D.1)

1)Department of Neurology, Yamaguchi Prefectural Grand Medical Center
2)Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine
3)Department of Pediatrics, Yamaguchi Prefectural Grand Medical Center

Many cases of acute flaccid paralysis occurred during an enterovirus D68 (EV-D68) outbreak in North America in the fall of 2014, and this epidemic has been newly defined as a distinct disease entity named acute flaccid myelitis (AFM). This disease entity is relatively popular among pediatricians, whereas it remains little-known among neurologists in Japan. We reported a 7-year-old girl with AFM, in whom severe limb weakness and respiratory failure developed five days after appearance of respiratory symptoms. Clinical features of our case were mimicked by those of acute axonal motor neuropathy at early stage of the disease, and this resulted in delayed diagnosis of AFM. DNA of EV-D68 was not detected. There are few reported cases of severe AFM, in which artificial ventilation is needed for a long time including both acute and recovery phases of the illness, and functional prognosis of AFM is discussed by literature.
Full Text of this Article in Japanese PDF (499K)

(CLINICA NEUROL, 59: 579|583, 2019)
key words: acute flaccid paralysis, acute flaccid myelitis, enterovirus D68, respiratory failure

(Received: 7-May-19)