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Acute Flaccid Myelitis With Neuroradiological Finding of Brachial Plexus Swelling.
Pediatr Neurol. 2020 Aug; 109:85-88.PN

Abstract

BACKGROUND

Acute flaccid myelitis is a recently defined clinically distinct syndrome of polio-like acute flaccid paralysis. Acute flaccid myelitis cases show characteristic neuroradiological features of longitudinal spinal cord lesions with predominant gray matter involvement. Current evidence suggests injury to the anterior horn neurons as the underlying mechanism.

METHODS

We describe three patients with acute flaccid myelitis who developed flaccid upper limb weakness with diminished deep tendon reflexes after prodromal fever. Spinal magnetic resonance imaging (MRI) (axial and sagittal T1- and T2-weighted sequences) and brachial plexus MRI (coronal short tau inversion recovery sequence) at the acute stage were performed.

RESULTS

Spinal MRI showed extensive longitudinal lesion in the spinal cord with predominant gray matter involvement. We were able to demonstrate concurrent swelling and hyperintensity in the brachial plexus in all the three patients at the acute stage.

CONCLUSION

The coexisting signal intensities suggest an extension of acute flaccid myelitis pathology to the brachial plexus, highlighting the possible peripheral nerve involvement in acute flaccid myelitis.

Authors+Show Affiliations

Department of Pediatric Neurology, Fukuoka Children's Hospital, Fukuoka, Japan. Electronic address: chong.p.f@fcho.jp.Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.Department of Pediatrics, Kameda Medical Center, Chiba, Japan.Department of Radiology, Graduate School and Faculty of Medicine, The University of Tokyo, Tokyo, Japan.Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan.Department of Pediatric Neurology, Fukuoka Children's Hospital, Fukuoka, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32409123

Citation

Chong, Pin Fee, et al. "Acute Flaccid Myelitis With Neuroradiological Finding of Brachial Plexus Swelling." Pediatric Neurology, vol. 109, 2020, pp. 85-88.
Chong PF, Yoshida T, Yuasa S, et al. Acute Flaccid Myelitis With Neuroradiological Finding of Brachial Plexus Swelling. Pediatr Neurol. 2020;109:85-88.
Chong, P. F., Yoshida, T., Yuasa, S., Mori, H., Tanaka-Taya, K., & Kira, R. (2020). Acute Flaccid Myelitis With Neuroradiological Finding of Brachial Plexus Swelling. Pediatric Neurology, 109, 85-88. https://doi.org/10.1016/j.pediatrneurol.2020.04.004
Chong PF, et al. Acute Flaccid Myelitis With Neuroradiological Finding of Brachial Plexus Swelling. Pediatr Neurol. 2020;109:85-88. PubMed PMID: 32409123.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute Flaccid Myelitis With Neuroradiological Finding of Brachial Plexus Swelling. AU - Chong,Pin Fee, AU - Yoshida,Takeshi, AU - Yuasa,Shota, AU - Mori,Harushi, AU - Tanaka-Taya,Keiko, AU - Kira,Ryutaro, Y1 - 2020/04/13/ PY - 2020/02/25/received PY - 2020/04/03/revised PY - 2020/04/04/accepted PY - 2020/5/16/pubmed PY - 2020/5/16/medline PY - 2020/5/16/entrez KW - Acute flaccid myelitis KW - Brachial plexus swelling KW - MR neurography KW - Peripheral nerve KW - STIR SP - 85 EP - 88 JF - Pediatric neurology JO - Pediatr. Neurol. VL - 109 N2 - BACKGROUND: Acute flaccid myelitis is a recently defined clinically distinct syndrome of polio-like acute flaccid paralysis. Acute flaccid myelitis cases show characteristic neuroradiological features of longitudinal spinal cord lesions with predominant gray matter involvement. Current evidence suggests injury to the anterior horn neurons as the underlying mechanism. METHODS: We describe three patients with acute flaccid myelitis who developed flaccid upper limb weakness with diminished deep tendon reflexes after prodromal fever. Spinal magnetic resonance imaging (MRI) (axial and sagittal T1- and T2-weighted sequences) and brachial plexus MRI (coronal short tau inversion recovery sequence) at the acute stage were performed. RESULTS: Spinal MRI showed extensive longitudinal lesion in the spinal cord with predominant gray matter involvement. We were able to demonstrate concurrent swelling and hyperintensity in the brachial plexus in all the three patients at the acute stage. CONCLUSION: The coexisting signal intensities suggest an extension of acute flaccid myelitis pathology to the brachial plexus, highlighting the possible peripheral nerve involvement in acute flaccid myelitis. SN - 1873-5150 UR - https://www.unboundmedicine.com/medline/citation/32409123/Acute_Flaccid_Myelitis_With_Neuroradiological_Finding_of_Brachial_Plexus_Swelling L2 - https://linkinghub.elsevier.com/retrieve/pii/S0887-8994(20)30120-X DB - PRIME DP - Unbound Medicine ER -
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