Enteroviral Rhombencephalitis with Abducens Nerve Palsy and Cardio-Pulmonary Failure in a 2-Year-Old Boy.
Chien-Yu LinShih-Yu HuangChuen-Bin JiangChun-Chih PengHsin ChiNan-Chang ChiuPublished in: Children (Basel, Switzerland) (2022)
Enterovirus infection is endemic in many areas, especially in Southeast Asia. Enterovirus infection with severe complications (EVSC) is life-threatening, and timely diagnosis and management are crucial for successful management. Here, we report on a 2-year-old boy with hand, foot, and mouth disease. Myoclonic jerks developed and left abducens nerve palsy followed. Brain magnetic resonance imaging (MRI) showed rhombencephalitis. Pulmonary edema and cardiopulmonary failure developed, and intravenous immunoglobulin and extracorporeal membrane oxygenation were administered. He had a tracheostomy with home ventilator use after 64 days of hospitalization. At a 5-year follow-up, his neurodevelopment was normal with complete recovery from the abducens nerve palsy. The progress of EVSC may be rapid and fulminant, and timely diagnosis is critical for patient prognosis and outcomes. The presence of abducens nerve palsy is an indicator of enteroviral rhombencephalitis, and immediate and appropriate management is suggested.
Keyphrases
- extracorporeal membrane oxygenation
- magnetic resonance imaging
- acute respiratory distress syndrome
- peripheral nerve
- pulmonary hypertension
- mechanical ventilation
- contrast enhanced
- respiratory failure
- risk factors
- early onset
- high dose
- metabolic syndrome
- resting state
- magnetic resonance
- type diabetes
- hepatitis b virus
- intensive care unit
- diffusion weighted imaging
- adipose tissue
- multiple sclerosis
- skeletal muscle
- functional connectivity
- blood brain barrier
- subarachnoid hemorrhage
- insulin resistance
- weight loss
- loop mediated isothermal amplification
- quantum dots